Background: Portal vein system thrombosis (PVT) is an infrequent but potentially serious complication after laparoscopic splenectomy. Patients with β-thalassemia are at higher risk as they have splenomegaly and hypercoagulability.
Subjects And Methods: Forty-eight β-thalassemia patients who underwent hand-assisted laparoscopic splenectomy or laparoscopic splenectomy were studied prospectively with pre- and postoperative Doppler ultrasonography or computed tomography scanning.
Results: The incidence of PVT was 8.3% (95% confidence interval [CI] 0.2%-16.4%) (4 of 48 patients). Spleen weight was the only independent factor associated with the presence of PVT. The odds ratio for spleen weight (100 g increase) was 1.46 (95% CI 1.10-1.94, P=.010). Receiver operator characteristic curve analysis showed that the optimal cutoff of spleen weight to the prediction of PVT was 1543 g. Thrombosis resolution was observed after a median of 165 days.
Conclusions: Patients with β-thalassemia who undergo laparoscopic-assisted splenectomy are at high risk of postoperative PVT. Close postoperative surveillance and aggressive coagulation prophylaxis are needed in these patients. Larger studies are required to confirm the present findings.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1089/lap.2012.0268 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Application of Laparoscopic Partial Splenectomy with Total Blood Flow Occlusion in Benign Splenic Lesions.
J Vis Exp
December 2024
Department of Hepatobiliary and Pancreatic-Spleen Surgery, Shunde Hospital of Southern Medical University, First People's Hospital of Shunde;
Laparoscopic partial splenectomy (LPS) is gradually becoming the preferred method for treating benign splenic lesions. However, due to the abundant blood supply and its soft, fragile tissue texture, especially when the lesion is located near the splenic hilum or is particularly large, performing partial splenectomy (PS) in clinical practice is extremely challenging. Therefore, we have been continuously exploring and optimizing hemorrhage control methods during PS, and we here propose a method to perform LPS with complete spleen blood flow occlusion.
View Article and Find Full Text PDFLaparoscopic Warshaw Procedure for Solid Pseudopapillary Neoplasms in Children.
Am Surg
January 2025
Department of Pediatric Surgery, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
Background: Solid pseudopapillary neoplasms (SPNs) arising in the body or tail of the pancreas can be amenable to laparoscopic distal pancreatectomy with or without concomitant splenectomy. The purpose of this study was to evaluate laparoscopic distal pancreatectomy for SPN using the Warshaw technique as a means to preserve spleens in children.
Methods: We reviewed our database of SPN patients 19 years and younger (January 2006-December 2023).
Case report: Anesthesia management for surgical treatment of glucagonoma with symptom of characterized necrolytic migratory erythema.
Front Oncol
December 2024
Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China.
Background: The anesthetic management of patients with glucagonoma is complicated by a number of factors including glucose fluctuation, characterized necrolytic migratory erythema in oral and pharyngeal, which may lead to an unexpected difficult airway.
Case Presentation: Herein we describe the anesthetic considerations and management of a 47-year-old adult with glucagonoma, who presented for a laparoscopic splenectomy and distal pancreatectomy procedure.
Conclusion: This report details fiberoptic intubation in an adult with glucagonoma and necrolytic migratory erythema.
[A prospective study of the effect of laparoscopic splenectomy and azygoportal disconnection on liver synthetic function and liver cirrhosis].
Zhonghua Wai Ke Za Zhi
January 2025
Department of Hepatobiliary Surgery, Northern Jiangsu People's Hospital, Yangzhou225001, China.
To investigate the effect of laparoscopic splenectomy and azygoportal disconnection (LSD) on liver synthesis and development of liver cirrhosis. This is a prospective case series study.The clinical data of liver cirrhotic patients with portal hypertension who received LSD at the Department of Hepatobiliary Surgery of Northern Jiangsu People's Hospital Affiliated to Yangzhou University from September 2014 to January 2016 were included.
View Article and Find Full Text PDFDefecation-Induced Splenic Rupture in a Patient With Portal Vein Thrombosis After Sleeve Gastrectomy: Case Report and Literature Review.
Cureus
December 2024
General Surgery, Atlas University, Istanbul, TUR.
Article Synopsis
- Sleeve gastrectomy is the most common bariatric surgery and generally safe, but splenic rupture due to portomesenteric vein thrombosis (PVT) is a rare and serious complication.
- A 38-year-old obese female experienced severe abdominal pain 13 days post-surgery, leading to the discovery of PVT and a splenic hematoma through imaging.
- Following the development of hypotension and tachycardia, she underwent an emergency surgery for splenic rupture, received low-molecular-weight heparin, and was discharged 10 days later, highlighting the need for close monitoring of patients post-bariatric surgery for signs of PVT and related complications.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!