Analysis of the changes in liver volume after splenectomy combined with devascularization for patients with cirrhotic portal hypertension
10.3760/cma.j.cn113884-20240820-00250
- VernacularTitle:肝硬化门静脉高压症患者脾切除联合断流术后肝脏体积变化情况分析
- Author:
Zhijun DAI
1
;
Mingguo TIAN
;
Yang BU
;
Baoding LI
;
Liyun WANG
;
Yong YANG
;
Xiaohong WU
;
Xiaoyan ZHANG
Author Information
1. 宁夏回族自治区人民医院医学影像中心，银川 750002
- Publication Type:Journal Article
- Keywords:
Liver cirrhosis;
Portal hypertension;
Splenectomy combined with devascularization;
Liver volume;
Portal vein thrombosis
- From:
Chinese Journal of Hepatobiliary Surgery
2024;30(12):893-896
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the changes of the liver volume in patients with cirrhotic portal hypertension after splenectomy combined with devascularization, and to analyze the related causes.Methods:Clinical and imaging data of 94 patients with cirrhotic portal hypertension who underwent surgical treatment at the People's Hospital of Ningxia Hui Autonomous Region between January 2014 and May 2024 were included and analyzed before and after surgery. The cohort comprised 61 males and 33 females, aged (47±12) years. The preoperative and postoperative liver volumes were compared, and the patients were divided into two groups based on the changes in postoperative liver volume: the volume increase group ( n=51) and the volume decrease group ( n=43). Clinical data were collected including liver volume, hepatic artery diameter, spontaneous portosystemic shunt (SPSS), portal vein thrombosis (PVT), and hepatic artery dilation. Results:Compared with the volume decrease group, the postoperative liver volume [(1 157±237) cm 3 vs. (977±271) cm 3] and incidence of hepatic artery dilation [92.2%(47/51) vs. 67.4%(29/43)] in the volume increase group both increased, while the incidence of newly formed SPSS [3.9%(2/51) vs. 18.6%(8/43)] and PVT [5.9%(3/51) vs. 34.9%(15/43)] after surgery both decreased, and the differences were statistically significant (all P<0.05). After splenectomy combined with devascularization, patients with decreased liver volume exhibited aggravated conditions of serrated or wavy changes at the edge of the liver and widening of liver fissures, while patients with increased liver volume had significant reduction or disappearance of serrated or wavy changes at the edge of the liver and narrowing of liver fission. Conclusion:Splenectomy combined with devascularization can increase the postoperative liver volume in patients with cirrhotic portal hypertension, and decrease in postoperative liver volume may be related to the occurrence of SPSS and PVT.
