Role of splenectomy in patients with hepatocellular carcinoma and hypersplenism

Sung Hoon Kim, doyoung kim, Jin Hong Lim, Seungup Kim, Gi Hong Choi, SangHoon Ahn, Jin Sub Choi, Kyung Sik Kim

Research output: Contribution to journalArticle

18 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 1

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Hypersplenism
Splenectomy
Hepatocellular Carcinoma
Liver
Thrombosis
Liver Failure
International Normalized Ratio
Mortality
Prothrombin Time
Portal Hypertension
Portal Vein
Platelet Count
Leukocyte Count
Bilirubin
Thrombocytopenia
Disease-Free Survival
Fibrosis
Survival

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Kim, Sung Hoon ; kim, doyoung ; Lim, Jin Hong ; Kim, Seungup ; Choi, Gi Hong ; Ahn, SangHoon ; Choi, Jin Sub ; Kim, Kyung Sik. / Role of splenectomy in patients with hepatocellular carcinoma and hypersplenism. In: ANZ Journal of Surgery. 2013 ; Vol. 83, No. 11. pp. 865-870.
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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.",
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Role of splenectomy in patients with hepatocellular carcinoma and hypersplenism. / Kim, Sung Hoon; kim, doyoung; Lim, Jin Hong; Kim, Seungup; Choi, Gi Hong; Ahn, SangHoon; Choi, Jin Sub; Kim, Kyung Sik.

In: ANZ Journal of Surgery, Vol. 83, No. 11, 01.11.2013, p. 865-870.

Research output: Contribution to journalArticle

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AU - Kim, Sung Hoon

AU - kim, doyoung

AU - Lim, Jin Hong

AU - Kim, Seungup

AU - Choi, Gi Hong

AU - Ahn, SangHoon

AU - Choi, Jin Sub

AU - Kim, Kyung Sik

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N2 - 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.

AB - 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.

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