Thrombosis in the portal venous system after elective laparoscopic splenectomy.
Surg Endosc
; 18(7): 1140-3, 2004 Jul.
Article
en En
| MEDLINE
| ID: mdl-15156376
BACKGROUND: The occurrence of thrombosis in the portal system is an underappreciated complication of splenectomy. Presenting symptoms are usually mild and nonspecific. The short hospital stay associated with the laparoscopic approach could delay the early diagnosis of this condition unless routine imaging controls are planned after discharge. METHODS: The records of 40 patients who underwent laparoscopic splenectomy at our institution were reviewed for clinical signs of thrombosis in the portal system and associated factors. All patients were also enrolled in a color Doppler ultrasound surveillance program. RESULTS: Nine patients (22.5%) developed thrombosis of the splenic vein, progressing to the portal vein in five cases (12.5%). Six patients (15%) were symptomatic. Thrombosis occurred even as late as 4 months after splenectomy. Spleen weight was the only significant factor predictive of postoperative thrombosis. The combination of splenomegaly and an elevated preoperative platelet count was associated with a 75% incidence of this complication. CONCLUSION: The high risk of thrombosis after the laparoscopic resection of large spleens should prompt strict postoperative imaging surveillance, combined with a more aggressive anticoagulation prophylaxis.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Vena Porta
/
Complicaciones Posoperatorias
/
Esplenectomía
/
Laparoscopía
/
Trombosis de la Vena
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Screening_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Surg Endosc
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
GASTROENTEROLOGIA
Año:
2004
Tipo del documento:
Article
País de afiliación:
Italia
Pais de publicación:
Alemania