Long-term therapeutic effects of partial splenic embolization on secondary hypersplenism.
- Author:
Jung Min LEE
1
;
Chae Yoon CHON
;
Jae Yong HAN
;
Ki Tae YOON
;
Chang Mo MOON
;
Sang Hoon AHN
;
Kwang Hyub HAN
;
Jong Tae LEE
;
Young Myoung MOON
Author Information
1. Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. cychon@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Therapeutic embolization;
Splenectomy;
Hypersplenism;
Liver cirrhosis
- MeSH:
Blood Platelets;
Embolization, Therapeutic;
Follow-Up Studies;
Hemorrhage;
Humans;
Hypersplenism*;
Liver;
Liver Cirrhosis;
Mortality;
Pancytopenia;
Prothrombin;
Retrospective Studies;
Splenectomy;
Thrombocytopenia
- From:Korean Journal of Medicine
2007;72(5):470-479
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Liver cirrhosis causes secondary hypersplenism and thrombocytopenia is clinically troublesome. Splenectomy (SPL) was thought to be the curative management for correcting thrombocytopenia. However, decompensated liver function prevents any surgical approach due to high morbidity and mortality. Hence, partial splenic embolization (PSE) has been introduced, which is a less invasive procedure. The purpose of this study was to assess the long-term therapeutic effects of PSE and to compare them with those of SPL. METHODS: This study was performed retrospectively in patients who underwent PSE or SPL from Jan. 1999 to Dec. 2003. The patients either had symptoms of bleeding or they needed to correct their thrombocytopenia for further treatment of associated diseases. The therapeutic effects were evaluated, and the complications were assessed. RESULTS: Forty and 35 patients were enrolled in the PSE and SPL groups, respectively. WBC, platelet and hemoglobin counts were all significantly increased at the 2 year follow-up in both groups. Child-Pugh score significantly decreased in the PSE group from 6.5 before treatment to 5.5 after treatment (p=0.004). Minor complications were easily controlled with supportive care, and major complications very rarely occurred in both groups. CONCLUSIONS: PSE and SPL both proved to be effective measures with few serious complications for treating pancytopenia in patients with liver cirrhosis. Considering the improved liver function (the prothrombin time) and the Child-Pugh score after PSE, it may be more reasonable to initially recommend PSE for the patients with liver cirrhosis and secondary hypersplenism.
