Clinical observation and risk assessment after splenectomy in hepatolenticular degeneration patients associated with hypersplenism.
complication
hepatolenticular degeneration
hypersplenism
liver function
splenectomy
Journal
Frontiers in surgery
ISSN: 2296-875X
Titre abrégé: Front Surg
Pays: Switzerland
ID NLM: 101645127
Informations de publication
Date de publication:
2022
2022
Historique:
received:
18
06
2022
accepted:
01
09
2022
entrez:
10
10
2022
pubmed:
11
10
2022
medline:
11
10
2022
Statut:
epublish
Résumé
Both hepatolenticular degeneration (HLD) and viral hepatitis B (HBV) can cause hypersplenism, but whether splenectomy is needed or can be performed in HLD patients associated with hypersplenism is still controversial. At present, HLD combined with hypersplenism has not been listed as the indication of splenectomy. This study aimed to investigate the efficacy, risks, and postoperative complications of splenectomy in HLD patients associated with hypersplenism. We retrospectively analyzed the clinical data of 180 HLD patients with hypersplenism who underwent splenectomy in the Department of General Surgery, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, from January 2001 to December 2015. To evaluate the efficacy of splenectomy, the hemogram of white blood cells (WBC), red blood cells (RBC), platelets (PLT), and the liver function indexes including alanine aminotransferase, aspartate aminotransferase, and total bilirubin were recorded before surgery and 1, 3, 5, 7, and 14 days after surgery. In addition, the clinical data of 142 HBV patients with hypersplenism who underwent splenectomy over the same period were also recorded and compared with that of HLD patients. In particular, aiming to assess the risks of splenectomy in HLD, we also compared postoperative complications and 36-month mortality between the two groups. The level of WBC, RBC, and PLT were all elevated after splenectomy in both the HLD group and the HBV group. However, there was no significant difference in the variation of hemogram after splenectomy between the two groups ( After splenectomy, the hemogram as well as liver function in the HLD group improved a lot and showed a consistent tendency with that in the HBV group. Meanwhile, compared to the HBV group, there was no significant difference in the incidence of postoperative complications in the HLD group. All these results indicate that splenectomy in HLD patients combined with hypersplenism is completely feasible and effective.
Sections du résumé
Background
UNASSIGNED
Both hepatolenticular degeneration (HLD) and viral hepatitis B (HBV) can cause hypersplenism, but whether splenectomy is needed or can be performed in HLD patients associated with hypersplenism is still controversial. At present, HLD combined with hypersplenism has not been listed as the indication of splenectomy.
Objective
UNASSIGNED
This study aimed to investigate the efficacy, risks, and postoperative complications of splenectomy in HLD patients associated with hypersplenism.
Methods
UNASSIGNED
We retrospectively analyzed the clinical data of 180 HLD patients with hypersplenism who underwent splenectomy in the Department of General Surgery, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, from January 2001 to December 2015. To evaluate the efficacy of splenectomy, the hemogram of white blood cells (WBC), red blood cells (RBC), platelets (PLT), and the liver function indexes including alanine aminotransferase, aspartate aminotransferase, and total bilirubin were recorded before surgery and 1, 3, 5, 7, and 14 days after surgery. In addition, the clinical data of 142 HBV patients with hypersplenism who underwent splenectomy over the same period were also recorded and compared with that of HLD patients. In particular, aiming to assess the risks of splenectomy in HLD, we also compared postoperative complications and 36-month mortality between the two groups.
Result
UNASSIGNED
The level of WBC, RBC, and PLT were all elevated after splenectomy in both the HLD group and the HBV group. However, there was no significant difference in the variation of hemogram after splenectomy between the two groups (
Conclusion
UNASSIGNED
After splenectomy, the hemogram as well as liver function in the HLD group improved a lot and showed a consistent tendency with that in the HBV group. Meanwhile, compared to the HBV group, there was no significant difference in the incidence of postoperative complications in the HLD group. All these results indicate that splenectomy in HLD patients combined with hypersplenism is completely feasible and effective.
Identifiants
pubmed: 36211271
doi: 10.3389/fsurg.2022.972561
pmc: PMC9539271
doi:
Types de publication
Journal Article
Langues
eng
Pagination
972561Informations de copyright
© 2022 Zhang, Yu, Peng, Zheng and Zhou.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Trans Am Neurol Assoc. 1951;56:79-84
pubmed: 14913592
Neurol Sci. 2019 May;40(5):1059-1066
pubmed: 30644005
Semin Liver Dis. 2011 Aug;31(3):245-59
pubmed: 21901655
Am J Med. 1953 Oct;15(4):450-8
pubmed: 13092114
Int J Surg. 2015 May;17:10-4
pubmed: 25779211
J Clin Med. 2018 Dec 14;7(12):
pubmed: 30558132
Surg Endosc. 2012 Dec;26(12):3391-400
pubmed: 22648114
Hepatology. 2018 Apr;67(4):1560-1599
pubmed: 29405329
Transplantation. 2003 Apr 15;75(7):1003-6
pubmed: 12698088
Lancet. 1982 Mar 20;1(8273):643-7
pubmed: 6121964
Nat Genet. 1993 Dec;5(4):344-50
pubmed: 8298641
Am Surg. 2020 Apr 1;86(4):334-340
pubmed: 32391757
Int Surg. 2013 Jan-Mar;98(1):55-60
pubmed: 23438277
J Egypt Soc Parasitol. 2011 Dec;41(3):601-10
pubmed: 22435153
Surgery. 2017 Mar;161(3):584-591
pubmed: 28040257
Neurol Sci. 2015 Nov;36(11):2111-5
pubmed: 26219584
Am Surg. 2019 Nov 1;85(11):1288-1293
pubmed: 31775973
J Ultrasound Med. 2009 Apr;28(4):471-7
pubmed: 19321675
Mol Med Rep. 2014 Feb;9(2):487-92
pubmed: 24336960
Thromb Haemost. 2021 Jul;121(7):867-876
pubmed: 33525037
Am J Hematol. 1980;9(3):269-75
pubmed: 7234865
Surg Endosc. 1999 Dec;13(12):1220-5
pubmed: 10594270
Adv Ther. 2021 Apr;38(4):1904-1930
pubmed: 33687650
Acta Gastroenterol Belg. 2021 Jan-Mar;84(1):51-56
pubmed: 33639693
Lancet. 1956 Jan 7;270(6906):25-6
pubmed: 13279157
Clin Genet. 2017 Jul;92(1):69-79
pubmed: 27982432
Encephale. 2007 Dec;33(6):924-32
pubmed: 18789784
Hepatobiliary Pancreat Dis Int. 2012 Oct;11(5):489-93
pubmed: 23060393
Am J Med. 2008 May;121(5):371-5
pubmed: 18456028
Br J Surg. 1973 Aug;60(8):646-9
pubmed: 4541913
Blood. 2004 Nov 1;104(9):2623-34
pubmed: 15217831
N Engl J Med. 1957 Feb 7;256(6):235-42
pubmed: 13400241
Med Sci Monit. 2018 Jun 25;24:4355-4362
pubmed: 29937539
Chin Med Sci J. 2017 Jun 10;32(2):69-4
pubmed: 28693686
Blood. 2021 Mar 4;137(9):1233-1240
pubmed: 32911539
World J Hepatol. 2013 Mar 27;5(3):127-32
pubmed: 23556045
Clin Gastroenterol Hepatol. 2006 Aug;4(8):1069-71
pubmed: 16793346
World J Surg. 1998 Oct;22(10):1082-6
pubmed: 9747171
Brain. 2009 Aug;132(Pt 8):1997-2001
pubmed: 19634211
Int J Surg. 2014 Nov;12(11):1228-34
pubmed: 25311773
Brain. 2013 May;136(Pt 5):1476-87
pubmed: 23518715