Kuroki Tamotsu, Kitasato Amane, Tokunaga Takayuki, Takeshita Hiroaki, Taniguchi Ken, Maeda Shigeto, Fujioka Hikaru
Department of Surgery, Nagasaki Medical Center, National Hospital Organization, 2-1001-1, Kubara, Omura, Nagasaki, 856-8562, Japan.
Surg Today. 2018 Aug;48(8):804-809. doi: 10.1007/s00595-018-1655-6. Epub 2018 Mar 22.
Laparoscopic splenectomy (LS) has become the standard operative approach for splenectomy. Portal or splenic vein thrombosis (PSVT) is a serious and common complication after LS, and lethal complications of PSVT can occur when the portal vein is completely occluded by portal vein thrombosis (PVT). We aimed to clarify the predictors of PSVT after LS and to determine which of them were also predictors of PVT.
A total of 56 consecutive patients who underwent elective LS were enrolled in this study. The patients were divided into two groups based on the presence or absence of PSVT after LS. In addition, patients with PSVT were divided into two groups: a PVT group and a non-PVT group. The preoperative and intraoperative clinical data were compared among the groups.
Thirty (53.6%) patients developed PSVT. The splenic vein diameter was the most useful predictor for the development of PSVT, and 10 mm was an accurate splenic vein diameter cut-off value for use as a predictive factor for PSVT. In addition, the splenic vein diameter was the most useful predictor of the development of PVT from splenic vein thrombosis (SVT), and 14 mm was found to be an accurate cut-off value.
PSVT is a common postoperative complication that is identified on enhanced computed tomography. The splenic vein diameter is not only a predictor of PSVT but also of the development of PVT from SVT.
腹腔镜脾切除术（LS）已成为脾切除术的标准手术方式。门静脉或脾静脉血栓形成（PSVT）是LS术后一种严重且常见的并发症，当门静脉被门静脉血栓形成（PVT）完全阻塞时，PSVT可导致致命并发症。我们旨在明确LS术后PSVT的预测因素，并确定其中哪些也是PVT的预测因素。
本研究共纳入56例连续接受择期LS的患者。根据LS术后是否存在PSVT将患者分为两组。此外，将发生PSVT的患者分为两组：PVT组和非PVT组。比较各组术前和术中的临床资料。
30例（53.6%）患者发生PSVT。脾静脉直径是PSVT发生最有用的预测因素，10mm是作为PSVT预测因素的准确脾静脉直径截断值。此外，脾静脉直径是脾静脉血栓形成（SVT）发展为PVT最有用的预测因素，发现14mm是准确的截断值。
PSVT是增强计算机断层扫描中发现的常见术后并发症。脾静脉直径不仅是PSVT的预测因素，也是SVT发展为PVT的预测因素。
