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Updated: Jun 12, 2026

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
Post-gastrectomy spleen enlargement and esophageal varices: distal vs total gastrectomy
Takatsugu Oida1, Kenji Mimatsu, Hisao Kano
1Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Yamashita-cho, Naka-ku, Yokohama 231-8553, Japan. ooida.takatsugu@yokochu.jp
Aim:
To study the relationship between platelet count-to-spleen diameter ratio and post-gastrectomy esophageal varices (EVs) development in patients without liver cirrhosis or hepatitis.
Methods:
We retrospectively studied 92 patients who underwent gastrectomy. They were divided into 2 groups on the basis of the surgical treatment: the distal gastrectomy (DG) group and total gastrectomy (TG) group. The incidence of EVs was determined and postoperative platelet counts, spleen diameters, and platelet count-to-spleen diameter ratios were compared between the 2 groups.
Results:
EVs were not detected during the first 6 mo after surgery in either group; however, at 12 mo after surgery, EVs were detected in 2 patients (3%) in the DG group and in 1 patient (3.6%) in the TG group; their mean platelet count-to-spleen diameter ratio was 2628 +/- 409, and 2604 +/- 360, respectively.
Conclusion:
Endoscopy should be performed to detect EVs when the platelet count-to-spleen diameter ratio is < 2600.
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