Risk factors for complications after partial splenic embolization for liver cirrhosis

Author:

Hayashi H1,Beppu T1,Okabe K2,Masuda T1,Okabe H1,Baba H1

Affiliation:

1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

2. Department of Surgery, Nippon Telegraph and Telephone West Corporation, Kyushu Hospital, Kumamoto, Japan

Abstract

Abstract Background Partial splenic embolization (PSE) in patients with cirrhosis can achieve a prolonged increase in blood cell count. However, there is little information on the risk factors for complications after PSE for liver cirrhosis. Methods Seventy patients (41 men and 29 women) with cirrhosis-induced hypersplenism underwent PSE. Based on the Child–Pugh classification, 30, 35 and five patients had class A, B and C disease respectively. Risk factors for complications after PSE were examined retrospectively by logistic regression analysis. Results The mean splenic infarction rate was 77·1 per cent. Twelve patients (17 per cent) had complications following PSE. In univariable analysis, Child–Pugh class C, total bilirubin level of 1·4 mg/dl or more, serum albumin level of 2·8 g/dl or less and infarcted splenic volume of 540 ml or more were significantly associated with complications after PSE. In multivariable analysis, Child–Pugh class C (P = 0·012) and infarcted splenic volume of 540 ml or more (P = 0·031) were identified as risk factors, with an odds ratio of 22·92 and 5·01 respectively. Conclusion Child–Pugh class C and a large splenic infarction volume are risk factors for complications after PSE for liver cirrhosis.

Publisher

Oxford University Press (OUP)

Subject

Surgery

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4. Partial splenic embolization for the treatment of hypersplenism in cirrhosis;Sangro;Hepatology,1993

5. Partial splenic embolization, an alternative to splenectomy—results of a prospective, randomized study;Mozes;Surgery,1984

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