Role of splenectomy in patients with hepatocellular carcinoma and hypersplenism

Sung Hoon Kim, Do Young Kim, Jin Hong Lim, Seung Up Kim, Gi Hong Choi, Sang Hoon Ahn, Jin Sub Choi, Kyung Sik Kim

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Introduction: Hypersplenism with thrombocytopenia is a common complication of cirrhosis with portal hypertension. We evaluated the role of splenectomy in patients with hepatocellular carcinoma (HCC) in terms of the improvement of biochemical indices and liver volume. Methods: Nineteen patients with HCC underwent liver resection and splenectomy from January 2000 to December 2009. Thirty-nine patients who underwent liver resection during the same period were enrolled as case-matched controls. We performed a retrospective review of prospectively collected data. We analysed the results of biochemical tests, disease-free survival and overall survival and measured the liver volume before and at 90 days after operation. Results: Preoperative white blood cell counts (P = 0.001), platelet counts (P = 0.021), total bilirubin (P ≤ 0.001) and prothrombin time by international normalized ratio (P = 0.043) were significantly different. However, these results had converged to similar levels 90 days after the operation. The degree of increment in liver volume were similar (P = 0.763). In splenectomy group, portal vein thrombosis developed in eight patients and all patients except one recovered using only conservative treatments. There was an operative mortality because of liver failure by thrombosis. Conclusions: Although splenectomy may induce thrombosis, liver failure and subsequent mortality, splenectomy may improve liver function and expand the indication of liver resection if postoperative management is conducted conservatively. 2012 Royal Australasian College of Surgeons.

Original languageEnglish
Pages (from-to)865-870
Number of pages6
JournalANZ Journal of Surgery
Volume83
Issue number11
DOIs
Publication statusPublished - 2013 Nov

All Science Journal Classification (ASJC) codes

  • Surgery

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