Naslov
Does the size and malignancy lead to higher incidence of portal vein thrombosis after laparoscopic splenectomy?

Autori
Stipančić, Igor ; Baković, Josip ; Kliček, Robert ; Knežević, Mario ; Kolak, Toni ; Runjić, Ivana ; Miočinović, Milan

Izvornik
Surgical endoscopy (0930-2795) 28 (2014); S168-S168

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, sažetak, ostalo

Ključne riječi
laparoscopy ; splenectomy ; portal vein thrombosis

Sažetak
Aims: Portal vein thrombosis may be a potentially life-threatening complication after splenectomy. Nonspecific and mild onset of symptoms are reason for delay in diagnosis, and the short hospital stay after laparoscopic approach could even contribute to the difficulty of early detection of this condition. Goal of this paper is to assess the impact of diagnosis and spleen size on the incidence of portal vein thrombosis. Methods: The data were collected prospectively from May 2003. to January 2013. in all patients (N=42) that underwent laparoscopic splenectomy in Clinical Hospital “Dubrava” Zagreb, Croatia. The impact of diagnosis (benign/malignant) and the spleen size on the incidence of portal vein thrombosis following laparoscopic splenectomy were evaluated. Patients underwent surveillance for portal vein thrombosis using ultrasonography on the 5th postoperative day. Results: Fourty-two patients underwent laparoscopic splenectomy. Majority of patients submitted to laparoscopic splenectomy had benign splenic disease (31 of 42), more than half of them had splenomegaly (24 of 42). Almost all patients with splenic malignancy have splenomegaly (8 of 11). The mean spleen size in splenomegaly patients was 23.88 cm (range 15-31 cm). Portal vein thrombosis occurred in 3 (7.1%) of 42 patients. All three had ITP and in two cases splen was normal size. Only in one patient with normal spleen size portal vein thrombosis was symptomatic. Conclusion: Portal vein thrombosis should be suspected in patients with fever or abdominal pain after splenectomy. Our results on small group of patients, in contrast to general opinion, did not show that the splenomegaly or malignant disease bring higher risk of portal vein thrombosis. The incidence of asympthomatic portal vein thrombosis justifies postoperative ultrasonographic screening.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

Napomena
Presented on 21st International Congress of the European Association for Endoscopic Surgery (EAES), Vienna, Austria, 19–22 June 2013.

POVEZANOST RADA