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Related Experiment Video

Updated: Jul 1, 2025

Bloodless Laparoscopic Partial Splenectomy Assisted by Bipolar Radiofrequency Excision Hemostatic Device
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Will partial splenic embolization followed by splenectomy increase intraoperative bleeding?

Long Huang1, Qing-Lin Li2, Qing-Sheng Yu3

  • 1Department of No. 1 Surgery, The First Hospital Affiliated to Anhui University of Traditional Chinese Medicine, Hefei 230031, Anhui Province, China. huanglong658@163.com.

World Journal of Gastrointestinal Surgery
|March 11, 2024
PubMed
Summary
This summary is machine-generated.

Partial splenic embolization before splenectomy for hypersplenism may increase intraoperative bleeding. A predictive model can identify patients at risk, aiding surgical decisions for cirrhosis patients.

Keywords:
Hypertension, PortalIntraoperative bleedingLiver CirrhosisPartial splenic embolizationSplenectomy

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Interventional Radiology

Background:

  • Partial splenic embolization (PSE) is an alternative to splenectomy for hypersplenism.
  • Recurrence of hypersplenism post-PSE may necessitate splenectomy.
  • Evidence is lacking on whether preoperative PSE reduces complications before splenectomy.

Purpose of the Study:

  • To evaluate the safety and efficacy of preoperative PSE followed by splenectomy.
  • To assess complications in patients with cirrhosis and hypersplenism.
  • To develop a predictive model for intraoperative bleeding (IB).

Main Methods:

  • Retrospective analysis of 321 patients with cirrhosis and hypersplenism undergoing splenectomy (2010-2021).
  • Comparison between a PSE group (n=40) and a non-PSE group (n=281) using propensity score matching (PSM).
  • Multivariable analysis and nomogram construction to predict IB, validated by ROC, Hosmer-Lemeshow, and DCA.

Main Results:

  • The non-PSE group had significantly shorter hospital stays, less intraoperative blood loss, and reduced operation times post-PSM.
  • Spleen length, portal vein diameter, splenic vein diameter, and PSE history independently predicted IB.
  • The nomogram demonstrated clinical utility in predicting IB; overall survival was similar between groups.

Conclusions:

  • Preoperative PSE followed by splenectomy may be associated with increased intraoperative bleeding.
  • A nomogram-based prediction model effectively predicts the occurrence of intraoperative bleeding.
  • Further research may optimize patient selection for combined procedures.