医学
血栓形成
脾切除术
外科
门静脉血栓形成
入射(几何)
腹痛
脾脏
脾静脉
逻辑回归
内科学
门脉高压
光学
物理
肝硬化
作者
Masataka Ikeda,Mitsugu Sekimoto,Shuji Takiguchi,Masayoshi Yasui,Katsuki Danno,Yujiro Fujie,Kotaro Kitani,Yosuke Seki,Taishi Hata,Tatsushi Shingai,Ichiro Takemasa,Masakazu Ikenaga,Hirofumi Yamamoto,Masayuki Ohue,Morito Monden
标识
DOI:10.1016/j.amjsurg.2006.06.036
摘要
Background Portal or splenic vein thrombosis (PSVT) is a common disorder after laparoscopic splenectomy (LS). Splenomegaly is a well-known risk factor for PSVT. However, no treatment strategy for PSVT has been established. Methods Thirty-three consecutive patients who had undergone LS and postoperative imaging surveillance were examined. PSVT was classified according to the site of thrombosis. We evaluated patient background, operative factors, and clinical symptoms. Results Spleen weight of patients with PSVT (n = 17, median 218 g) was greater than that of patients without PSVT (n = 16, median 101 g). Seven patients developed thrombosis involving the entire splenic vein (total splenic vein thrombosis), and 4 of them had clinical symptoms (fever >38°C and/or abdominal pain). The incidence of clinical symptoms was significantly more frequent in patients with than without total SVT. Operation time, blood loss, and spleen weight were also significantly greater in patients with total SVT. Multiple logistic regression analysis demonstrated spleen weight was the strongest predictor of PSVT and total SVT. Conclusion Patients with total SVT have greater risk factors for PSVT and frequently have clinical symptoms. They are candidates for anticoagulation therapy.
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