Non-selective versus highly selective partial splenic embolization in treating patients with hypersplenism secondary to liver cirrhosis: a comparative study
10.3760/cma.j.cn113884-20210527-00182
- VernacularTitle:脾动脉非选择性与高选择性插管后部分脾栓塞术在肝硬化继发脾功能亢进患者中的对比研究
- Author:
Qingyun XIE
1
;
Fengwei GAO
;
Zehua LEI
;
Kangyi JIANG
;
Jie GONG
;
Xin ZHAO
Author Information
1. 乐山市人民医院肝胆胰外科(乐山市肝胆胰脾系统性疾病诊疗中心)，四川乐山 614000
- Keywords:
Hypersplenism;
Liver cirrhosis;
Embolotherapy
- From:
Chinese Journal of Hepatobiliary Surgery
2021;27(12):917-922
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical outcomes of treatment using non-selective versus highly selective partial splenic embolization in patients with hypersplenism secondary to liver cirrhosis.Methods:The clinical data of patients with hypersplenism secondary to hepatitis B cirrhosis who underwent splenic embolization at the Department of Hepatobiliary and Pancreatic Surgery of Leshan People's Hospital from July 2017 to July 2020 were analyzed retrospectively. Of 65 patients with hypersplenism, there were 42 males and 23 females, with age of (58.5±9.8) years. Twenty-six patients underwent splenic artery non-selective partial splenic embolization (the non-selective group) and 39 patients underwent partial splenic embolization using highly selective intubation (the highly selective group). The postoperative peripheral hematological indexes, liver function, operation-related complications and portal vein color Doppler ultrasonography were compared between the two groups.Results:The white blood cell count and platelet count of patients in the 2 groups were significantly higher than those before operation. The white blood cell count at 4, 12 and 24 weeks after operation and the platelet count at 12 and 24 weeks after operation in the highly selective group were significantly higher than those in the non-selective group ( P<0.05). Compared with the non-selective group, the total bilirubin, ICG-R15, portal vein diameter and portal vein blood flow in the highly-selective group significantly lower ( P<0.05). The incidences of 0/Ⅰ/Ⅱ/Ⅲ pain in the non-selected group was significantly higher when compared with that in the highly selected group (5/10/11/1 vs. 12/22/7/0), ( P<0.05). There were no significant differences in the incidences of postoperative complication between the two groups ( P>0.05). Conclusion:Compared with non-selective partial splenic embolization, highly selective partial splenic embolization gave more stable and lasting treatment outcomes in patients with hypersplenism caused by liver cirrhosis with better recovery of blood-related indicators, better improvement in postoperative liver function and relief of portal hypertension symptoms.
