Targarona Eduard M
Service of General and Digestive Surgery, Hospital de Sant Pau, Autonomous University of Barcelona, Spain.
Surg Innov. 2008 Dec;15(4):266-70. doi: 10.1177/1553350608324931.
Portal vein thrombosis (PVT) after splenectomy is a potentially life-threatening complication. Clinical symptoms may be insidious, and progression can lead to intestinal infarction and portal hypertension. Interest in PVT has increased as a high incidence has been found in the laparoscopic setting. The higher incidence of PVT found in recent prospective studies of laparoscopically operated patients compared with retrospective reports from the 1990s suggests that PVT may have been underreported. Clinical outcome depends on the extension of the thrombus and the underlying disease. Main risk factors may be myeloproliferative diseases requiring splenectomy and splenomegaly, but PVT may occur after splenectomy for any clinical indication. The extent to which laparoscopy is responsible for PVT remains unclear. Laparoscopic surgeons should be aware of the risk of PVT, and it should be suspected in cases with an atypical outcome after laparoscopic splenectomy. Once diagnosed, prompt anticoagulation therapy may resolve the thrombotic event.
脾切除术后门静脉血栓形成（PVT）是一种潜在的危及生命的并发症。临床症状可能隐匿，病情进展可导致肠梗死和门静脉高压。随着腹腔镜手术中PVT的高发病率被发现，人们对其的关注度有所增加。与20世纪90年代的回顾性报告相比，近期腹腔镜手术患者前瞻性研究中发现的PVT更高发病率表明，PVT可能一直未得到充分报告。临床结局取决于血栓的扩展程度和基础疾病。主要危险因素可能是需要脾切除的骨髓增殖性疾病和脾肿大，但脾切除术后无论何种临床指征都可能发生PVT。腹腔镜手术导致PVT的程度尚不清楚。腹腔镜外科医生应意识到PVT的风险，对于腹腔镜脾切除术后出现非典型结局的病例应怀疑有PVT。一旦确诊，及时的抗凝治疗可能解决血栓形成事件。
