The Role of Splenectomy in Patients with Hepatocellular Carcinoma and Secondary Hypersplenism.
10.3349/ymj.2003.44.6.1053
- Author:
Jae Won OH
1
;
Soo Min AHN
;
Kyung Sik KIM
;
Jin Sub CHOI
;
Woo Jung LEE
;
Byung Ro KIM
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. choi5491@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Splenectomy;
hepatectomy;
hypersplenic thrombocytopenia (HSTC);
hepatocellular carcinoma (HCC)
- MeSH:
Adult;
Carcinoma, Hepatocellular/*complications/surgery;
Female;
Hepatectomy;
Human;
Hypersplenism/*etiology/*surgery;
Hypertension, Portal/*complications;
Liver Neoplasms/*complications/surgery;
Male;
Middle Aged;
*Splenectomy
- From:Yonsei Medical Journal
2003;44(6):1053-1058
- CountryRepublic of Korea
- Language:English
-
Abstract:
Hypersplenism, secondary to portal hypertension, is common in hepatocellular carcinoma (HCC) with liver cirrhosis. Hepatic resection in the patient with hypersplenic thrombocytopenia (HSTC) may cause a perioperative bleeding episode and sometimes, liver failure. In order to investigate the effect of concomitant splenectomy in HCC patients with HSTC, clinical parameters are retrospectively reviewed for 18 HCC patients who underwent hepatic resection with or without splenectomy. Among 581 HCC patients who underwent hepatic resection during the past 17 years, 18 patients with HSTC were investigated. Twelve of them underwent hepatic resection for HCC and had a concomitant splenectomy and the remaining 6 patients underwent hepatic resection for HCC only. The clinical outcomes and postoperative changes in platelet count, serum albumin level, serum total bilirubin levels, prothrombin time and clinical staging (Child-Pugh Classification) were reviewed. The resected spleen mean weight was 350.7+/-102.9 g. Postoperative platelet counts were significantly increased with albumin levels and clinical staging scores also improved after the splenectomy. Among the 12 patients who had a splenectomy, 6 patients had postoperative complications and one died of recurrent variceal bleeding. According to this data, it is not harmful to perform a concomitant splenectomy and hepatectomy for the HCC patient with severe HSTC, it can even be beneficial in improving both the platelet count and clinical staging.
