Hand-assisted laparoscopic splenectomy for thrombocytopenia in patients with cirrhosis
Purpose Although splenectomy plays an important role in the management of patients with liver cirrhosis, the optimal technique, open surgery, total laparoscopic surgery or hand-assisted laparoscopic surgery (HALS), has not yet been defined. The present study evaluated the outcomes of HALS splenectom...
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| Veröffentlicht in: | Surgery today (Tokyo, Japan) Japan), 2013-08, Vol.43 (8), p.883-888 |
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| container_title | Surgery today (Tokyo, Japan) |
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| creator | Kakinoki, Keitaro Okano, Keiichi Suto, Hironobu Oshima, Minoru Hagiike, Masanobu Usuki, Hisashi Deguchi, Akihiro Masaki, Tutomu Suzuki, Yasuyuki |
| description | Purpose
Although splenectomy plays an important role in the management of patients with liver cirrhosis, the optimal technique, open surgery, total laparoscopic surgery or hand-assisted laparoscopic surgery (HALS), has not yet been defined. The present study evaluated the outcomes of HALS splenectomy for cirrhotic patients.
Methods
A total of 28 consecutive patients with cirrhosis that underwent HALS splenectomy were enrolled into this study. The preoperative laboratory and morphometric data, intraoperative variables and postoperative outcomes were reviewed from the hospital charts.
Results
The postoperative platelet count was remarkably elevated in all cases. A re-operation was required in 1 patient complicated with postoperative hemorrhage. Enhanced CT on POD 7 revealed a high incidence of portal or splenic vein thrombosis (PSVT; 22 patients, 78.6 %). PSVT was significantly associated with higher serum bilirubin, higher indocyanine green retention value at 15 min (ICG R-15), and larger splenic vein diameter.
Conclusion
HALS splenectomy was a very feasible and appropriate procedure for cirrhotic patients with hypersplenism. PSVT was a frequent complication and large splenic vein diameter, high serum bilirubin, and high ICG R-15 were found to be significant risk factors for PSVT after HALS splenectomy in cirrhotic patients. |
| doi_str_mv | 10.1007/s00595-012-0413-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1399934656</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1399934656</sourcerecordid><originalsourceid>FETCH-LOGICAL-c430t-865df74791cbeb8442bbc467aac6976424fd2623d56910276290ecd1d35e2283</originalsourceid><addsrcrecordid>eNp9kLFOwzAURS0EglL4ABaUkcXgZztOPKIKKBISC2K1HMehRkkcbEeof4-rFkamN7xzr3QPQldAboGQ6i4SUsoSE6CYcGCYH6EFcCYwrYEdowWRHDBQCWfoPMZPQiivCTlFZ5RlDCpYoPe1HlusY3Qx2bbo9aSDj8ZPzhRx6u1oTfLDtuh8KNIm-KHxZpv8ZEenCzcWk07OjikW3y5tCuNC2PjcdYFOOt1He3m4S_T2-PC2WuOX16fn1f0LNpyRhGtRtl3FKwmmsU3NOW0aw0WltRGyEpzyrqWCsrYUEgitBJXEmhZaVlpKa7ZEN_vaKfiv2cakBheN7Xs9Wj9HBUxKybgoRUZhj5q8LwbbqSm4QYetAqJ2NtXepso21c6m4jlzfaifm8G2f4lffRmgeyDm1_hhg_r0cxjz4n9afwDgQ4Bl</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1399934656</pqid></control><display><type>article</type><title>Hand-assisted laparoscopic splenectomy for thrombocytopenia in patients with cirrhosis</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Kakinoki, Keitaro ; Okano, Keiichi ; Suto, Hironobu ; Oshima, Minoru ; Hagiike, Masanobu ; Usuki, Hisashi ; Deguchi, Akihiro ; Masaki, Tutomu ; Suzuki, Yasuyuki</creator><creatorcontrib>Kakinoki, Keitaro ; Okano, Keiichi ; Suto, Hironobu ; Oshima, Minoru ; Hagiike, Masanobu ; Usuki, Hisashi ; Deguchi, Akihiro ; Masaki, Tutomu ; Suzuki, Yasuyuki</creatorcontrib><description>Purpose
Although splenectomy plays an important role in the management of patients with liver cirrhosis, the optimal technique, open surgery, total laparoscopic surgery or hand-assisted laparoscopic surgery (HALS), has not yet been defined. The present study evaluated the outcomes of HALS splenectomy for cirrhotic patients.
Methods
A total of 28 consecutive patients with cirrhosis that underwent HALS splenectomy were enrolled into this study. The preoperative laboratory and morphometric data, intraoperative variables and postoperative outcomes were reviewed from the hospital charts.
Results
The postoperative platelet count was remarkably elevated in all cases. A re-operation was required in 1 patient complicated with postoperative hemorrhage. Enhanced CT on POD 7 revealed a high incidence of portal or splenic vein thrombosis (PSVT; 22 patients, 78.6 %). PSVT was significantly associated with higher serum bilirubin, higher indocyanine green retention value at 15 min (ICG R-15), and larger splenic vein diameter.
Conclusion
HALS splenectomy was a very feasible and appropriate procedure for cirrhotic patients with hypersplenism. PSVT was a frequent complication and large splenic vein diameter, high serum bilirubin, and high ICG R-15 were found to be significant risk factors for PSVT after HALS splenectomy in cirrhotic patients.</description><identifier>ISSN: 0941-1291</identifier><identifier>EISSN: 1436-2813</identifier><identifier>DOI: 10.1007/s00595-012-0413-4</identifier><identifier>PMID: 23143171</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Aged ; Bilirubin - blood ; Feasibility Studies ; Female ; Hand-Assisted Laparoscopy - methods ; Humans ; Indocyanine Green - metabolism ; Liver Cirrhosis - complications ; Liver Cirrhosis - surgery ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Postoperative Complications - epidemiology ; Prospective Studies ; Risk Factors ; Splenectomy - methods ; Splenic Vein - pathology ; Surgery ; Surgical Oncology ; Thrombocytopenia - complications ; Thrombocytopenia - surgery ; Treatment Outcome ; Venous Thrombosis - epidemiology</subject><ispartof>Surgery today (Tokyo, Japan), 2013-08, Vol.43 (8), p.883-888</ispartof><rights>Springer Japan 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c430t-865df74791cbeb8442bbc467aac6976424fd2623d56910276290ecd1d35e2283</citedby><cites>FETCH-LOGICAL-c430t-865df74791cbeb8442bbc467aac6976424fd2623d56910276290ecd1d35e2283</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00595-012-0413-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00595-012-0413-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23143171$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kakinoki, Keitaro</creatorcontrib><creatorcontrib>Okano, Keiichi</creatorcontrib><creatorcontrib>Suto, Hironobu</creatorcontrib><creatorcontrib>Oshima, Minoru</creatorcontrib><creatorcontrib>Hagiike, Masanobu</creatorcontrib><creatorcontrib>Usuki, Hisashi</creatorcontrib><creatorcontrib>Deguchi, Akihiro</creatorcontrib><creatorcontrib>Masaki, Tutomu</creatorcontrib><creatorcontrib>Suzuki, Yasuyuki</creatorcontrib><title>Hand-assisted laparoscopic splenectomy for thrombocytopenia in patients with cirrhosis</title><title>Surgery today (Tokyo, Japan)</title><addtitle>Surg Today</addtitle><addtitle>Surg Today</addtitle><description>Purpose
Although splenectomy plays an important role in the management of patients with liver cirrhosis, the optimal technique, open surgery, total laparoscopic surgery or hand-assisted laparoscopic surgery (HALS), has not yet been defined. The present study evaluated the outcomes of HALS splenectomy for cirrhotic patients.
Methods
A total of 28 consecutive patients with cirrhosis that underwent HALS splenectomy were enrolled into this study. The preoperative laboratory and morphometric data, intraoperative variables and postoperative outcomes were reviewed from the hospital charts.
Results
The postoperative platelet count was remarkably elevated in all cases. A re-operation was required in 1 patient complicated with postoperative hemorrhage. Enhanced CT on POD 7 revealed a high incidence of portal or splenic vein thrombosis (PSVT; 22 patients, 78.6 %). PSVT was significantly associated with higher serum bilirubin, higher indocyanine green retention value at 15 min (ICG R-15), and larger splenic vein diameter.
Conclusion
HALS splenectomy was a very feasible and appropriate procedure for cirrhotic patients with hypersplenism. PSVT was a frequent complication and large splenic vein diameter, high serum bilirubin, and high ICG R-15 were found to be significant risk factors for PSVT after HALS splenectomy in cirrhotic patients.</description><subject>Aged</subject><subject>Bilirubin - blood</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Hand-Assisted Laparoscopy - methods</subject><subject>Humans</subject><subject>Indocyanine Green - metabolism</subject><subject>Liver Cirrhosis - complications</subject><subject>Liver Cirrhosis - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Splenectomy - methods</subject><subject>Splenic Vein - pathology</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Thrombocytopenia - complications</subject><subject>Thrombocytopenia - surgery</subject><subject>Treatment Outcome</subject><subject>Venous Thrombosis - epidemiology</subject><issn>0941-1291</issn><issn>1436-2813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kLFOwzAURS0EglL4ABaUkcXgZztOPKIKKBISC2K1HMehRkkcbEeof4-rFkamN7xzr3QPQldAboGQ6i4SUsoSE6CYcGCYH6EFcCYwrYEdowWRHDBQCWfoPMZPQiivCTlFZ5RlDCpYoPe1HlusY3Qx2bbo9aSDj8ZPzhRx6u1oTfLDtuh8KNIm-KHxZpv8ZEenCzcWk07OjikW3y5tCuNC2PjcdYFOOt1He3m4S_T2-PC2WuOX16fn1f0LNpyRhGtRtl3FKwmmsU3NOW0aw0WltRGyEpzyrqWCsrYUEgitBJXEmhZaVlpKa7ZEN_vaKfiv2cakBheN7Xs9Wj9HBUxKybgoRUZhj5q8LwbbqSm4QYetAqJ2NtXepso21c6m4jlzfaifm8G2f4lffRmgeyDm1_hhg_r0cxjz4n9afwDgQ4Bl</recordid><startdate>20130801</startdate><enddate>20130801</enddate><creator>Kakinoki, Keitaro</creator><creator>Okano, Keiichi</creator><creator>Suto, Hironobu</creator><creator>Oshima, Minoru</creator><creator>Hagiike, Masanobu</creator><creator>Usuki, Hisashi</creator><creator>Deguchi, Akihiro</creator><creator>Masaki, Tutomu</creator><creator>Suzuki, Yasuyuki</creator><general>Springer Japan</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130801</creationdate><title>Hand-assisted laparoscopic splenectomy for thrombocytopenia in patients with cirrhosis</title><author>Kakinoki, Keitaro ; Okano, Keiichi ; Suto, Hironobu ; Oshima, Minoru ; Hagiike, Masanobu ; Usuki, Hisashi ; Deguchi, Akihiro ; Masaki, Tutomu ; Suzuki, Yasuyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c430t-865df74791cbeb8442bbc467aac6976424fd2623d56910276290ecd1d35e2283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Bilirubin - blood</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Hand-Assisted Laparoscopy - methods</topic><topic>Humans</topic><topic>Indocyanine Green - metabolism</topic><topic>Liver Cirrhosis - complications</topic><topic>Liver Cirrhosis - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Splenectomy - methods</topic><topic>Splenic Vein - pathology</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Thrombocytopenia - complications</topic><topic>Thrombocytopenia - surgery</topic><topic>Treatment Outcome</topic><topic>Venous Thrombosis - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kakinoki, Keitaro</creatorcontrib><creatorcontrib>Okano, Keiichi</creatorcontrib><creatorcontrib>Suto, Hironobu</creatorcontrib><creatorcontrib>Oshima, Minoru</creatorcontrib><creatorcontrib>Hagiike, Masanobu</creatorcontrib><creatorcontrib>Usuki, Hisashi</creatorcontrib><creatorcontrib>Deguchi, Akihiro</creatorcontrib><creatorcontrib>Masaki, Tutomu</creatorcontrib><creatorcontrib>Suzuki, Yasuyuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery today (Tokyo, Japan)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kakinoki, Keitaro</au><au>Okano, Keiichi</au><au>Suto, Hironobu</au><au>Oshima, Minoru</au><au>Hagiike, Masanobu</au><au>Usuki, Hisashi</au><au>Deguchi, Akihiro</au><au>Masaki, Tutomu</au><au>Suzuki, Yasuyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hand-assisted laparoscopic splenectomy for thrombocytopenia in patients with cirrhosis</atitle><jtitle>Surgery today (Tokyo, Japan)</jtitle><stitle>Surg Today</stitle><addtitle>Surg Today</addtitle><date>2013-08-01</date><risdate>2013</risdate><volume>43</volume><issue>8</issue><spage>883</spage><epage>888</epage><pages>883-888</pages><issn>0941-1291</issn><eissn>1436-2813</eissn><abstract>Purpose
Although splenectomy plays an important role in the management of patients with liver cirrhosis, the optimal technique, open surgery, total laparoscopic surgery or hand-assisted laparoscopic surgery (HALS), has not yet been defined. The present study evaluated the outcomes of HALS splenectomy for cirrhotic patients.
Methods
A total of 28 consecutive patients with cirrhosis that underwent HALS splenectomy were enrolled into this study. The preoperative laboratory and morphometric data, intraoperative variables and postoperative outcomes were reviewed from the hospital charts.
Results
The postoperative platelet count was remarkably elevated in all cases. A re-operation was required in 1 patient complicated with postoperative hemorrhage. Enhanced CT on POD 7 revealed a high incidence of portal or splenic vein thrombosis (PSVT; 22 patients, 78.6 %). PSVT was significantly associated with higher serum bilirubin, higher indocyanine green retention value at 15 min (ICG R-15), and larger splenic vein diameter.
Conclusion
HALS splenectomy was a very feasible and appropriate procedure for cirrhotic patients with hypersplenism. PSVT was a frequent complication and large splenic vein diameter, high serum bilirubin, and high ICG R-15 were found to be significant risk factors for PSVT after HALS splenectomy in cirrhotic patients.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>23143171</pmid><doi>10.1007/s00595-012-0413-4</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Bilirubin - blood Feasibility Studies Female Hand-Assisted Laparoscopy - methods Humans Indocyanine Green - metabolism Liver Cirrhosis - complications Liver Cirrhosis - surgery Male Medicine Medicine & Public Health Middle Aged Original Article Postoperative Complications - epidemiology Prospective Studies Risk Factors Splenectomy - methods Splenic Vein - pathology Surgery Surgical Oncology Thrombocytopenia - complications Thrombocytopenia - surgery Treatment Outcome Venous Thrombosis - epidemiology |
| title | Hand-assisted laparoscopic splenectomy for thrombocytopenia in patients with cirrhosis |
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