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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
04:00

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension

Published on: November 15, 2024

255

Coagulation Dysfunction in Patients with Liver Cirrhosis and Splenomegaly and Its Countermeasures: A Retrospective

Yunfu Lv1, Ning Liu1, Yejuan Li2

  • 1Department of General Surgery, Hainan General Hospital (Hainan Medical College Affiliated People's Hospital), Haikou, 570311 Hainan Province, China.

Disease Markers
|June 16, 2023
PubMed

Insights

Approximately 80% of patients with liver cirrhosis and splenomegaly experience coagulation dysfunction. Grade I and II patients can undergo surgery, while Grade III patients require initial nonsurgical treatment before considering surgery.

Area of Science:

  • Hepatology
  • Hematology
  • Surgical Oncology

Background:

  • Coagulation dysfunction is common in patients with cirrhosis and splenomegaly, impacting treatment and prognosis.
  • Understanding the prevalence and grading of this dysfunction is crucial for patient management.

Purpose of the Study:

  • To investigate the status, grading, and treatment strategies for coagulation dysfunction in patients with liver cirrhosis and splenomegaly.

Main Methods:

  • Retrospective cohort study of 1522 patients with cirrhosis and splenomegaly.
  • Data collected from January 2000 to December 2020.
  • Analysis of five coagulation tests: prothrombin time, prothrombin activity, activated partial thromboplastin time, thrombin time, and fibrinogen.

Main Results:

  • 80.5% of patients exhibited coagulation dysfunction in at least one test.
  • Coagulation dysfunction was graded I, II, and III based on prothrombin time, activated partial thromboplastin time, and fibrinogen.
  • Significant differences in surgical outcomes were observed across grades, with Grade III having a 6.5% operative mortality rate.

Conclusions:

  • Coagulation dysfunction affects a majority of patients with cirrhosis and splenomegaly.
  • Surgery is suitable for Grade I and II patients.
  • Grade III patients benefit from initial nonsurgical management, with surgery considered only after coagulation function improves.
Abstract

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