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Updated: Aug 29, 2026
Application of Laparoscopic Partial Splenectomy with Total Blood Flow Occlusion in Benign Splenic Lesions
Published on: December 20, 2024
Long-term efficacy of partial splenic embolization in children
Masaki Nio1, Yutaka Hayashi, Nobuyuki Sano
1Department of Pediatric Surgery, Tohoku University School of Medicine, Sendai, Japan.
Insights
Partial splenic embolization (PSE) is effective for treating hypersplenism, with 70% of survivors maintaining normal platelet counts long-term. Recurrence of thrombocytopenia occurred in 30.6% of patients.
Area of Science:
- Interventional Radiology
- Hepatology
- Hematology
Background:
- Hypersplenism, often caused by portal hypertension, leads to low platelet counts.
- Partial splenic embolization (PSE) is a minimally invasive procedure to treat hypersplenism.
Purpose of the Study:
- To evaluate the long-term effectiveness of PSE in patients with hypersplenism.
- To assess the recurrence rate of thrombocytopenia after PSE.
Main Methods:
- Retrospective study of 36 patients undergoing 41 PSE procedures for hypersplenism due to portal hypertension.
- Underlying conditions included biliary atresia, extrahepatic portal obstruction, and idiopathic cirrhosis.
- Average embolized splenic volume was 70.1% with follow-up up to 182 months.
Main Results:
- Hematologic indices improved in all patients post-PSE.
- Thrombocytopenia recurred in 11 patients (30.6%).
- In survivors without liver transplantation, 17 of 24 maintained normal platelet counts long-term.
Conclusions:
- Partial splenic embolization is a safe and effective treatment for hypersplenism.
- Long-term efficacy of PSE was demonstrated in approximately 70% of surviving patients.
- The procedure offers sustained hematologic improvement for a majority of patients.
Purpose:
To elucidate the role of partial splenic embolization (PSE) procedures, long-term outcome was assessed in terms of the recurrence of thrombocytopenia.
Methods:
A retrospective study was performed after 41 PSE procedures in 36 patients for hypersplenism owing to portal hypertension. The underlying disease was biliary atresia in 32 patients, extrahepatic portal obstruction in 3, and idiopathic cirrhosis in 1.
Results:
The average volume embolized was 70.1%. The patients were followed up from 20 days to 182 months (average, 70.8 months). Five patients subsequently died, and 6 underwent liver transplantation. The causes of death or the reasons for liver transplantation were not related to hypersplenism. Eleven patients (30.6%) had recurrence of thrombocytopenia (<100,000/mm3). There was no significant difference in the volume embolized or platelet count before PSE between the patients with and without recurrence of thrombocytopenia. The peak value of platelet count after PSE was significantly lower in the patients with recurrence of thrombocytopenia (P =.0091). In 17 of 24 survivors without liver transplantation, platelet counts remained normal throughout the follow-up period.
Conclusions:
PSE is a safe and effective procedure. Hematologic indices improved in all 36 patients after PSE, and its long-term efficacy was shown in 70% of the survivors.
