Splenic volume and splenic vein diameter are independent pre-operative risk factors of portal vein thrombosis after splenectomy: a retrospective cohort study
Abstract Background Portal vein thrombosis (PVT) is a common complication following splenectomy. It affects between 5 and 55% of patients undergoing surgery with no clearly defined pre-operative risk factors. The aim of this study was to determine the pre-operative risk factors of PVT. Patients and...
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-021-01364-3 |
| _version_ | 1818355319618666496 |
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| author | Guillaume Péré Hubert Basselerie Charlotte Maulat Armando Pitocco Pierrick Leblanc Antoine Philis Charles Henri Julio Géraud Tuyeras Etienne Buscail Nicolas Carrere |
| author_facet | Guillaume Péré Hubert Basselerie Charlotte Maulat Armando Pitocco Pierrick Leblanc Antoine Philis Charles Henri Julio Géraud Tuyeras Etienne Buscail Nicolas Carrere |
| author_sort | Guillaume Péré |
| collection | DOAJ |
| description | Abstract Background Portal vein thrombosis (PVT) is a common complication following splenectomy. It affects between 5 and 55% of patients undergoing surgery with no clearly defined pre-operative risk factors. The aim of this study was to determine the pre-operative risk factors of PVT. Patients and method Single centre, retrospective study of data compiled for every consecutive patient who underwent splenectomy at Toulouse University Hospital between January 2009 and January 2019. Patients with pre- and post-surgical CT scans have been included. Results 149 out of 261 patients were enrolled in the study (59% were males, mean age 52 years). The indications for splenectomy were splenic trauma (30.9%), malignant haemopathy (26.8%) and immune thrombocytopenia (8.0%). Twenty-nine cases of PVT (19.5%) were diagnosed based on a post-operative CT scan performed on post-operative day (POD) 5. Univariate analysis identifies three main risk factors associated with post-operative PVT: estimated splenic weight exceeding 500 g with an OR of 8.72 95% CI (3.3–22.9), splenic vein diameter over 10 mm with an OR of 4.92 95% CI (2.1–11.8) and lymphoma with an OR of 7.39 (2.7–20.1). The role of splenic vein diameter with an OR of 3.03 95% CI (1.1–8.6), and splenic weight with an OR of 5.22 (1.8–15.2), as independent risk factors is confirmed by multivariate analysis. A screening test based on a POD 5 CT scan with one or two of these items present could indicate sensitivity of 86.2% and specificity of 86.7%. Conclusion This study suggests that pre-operative CT scan findings could predict post-operative PVT. A CT scan should be performed on POD 5 if a risk factor has been identified prior to surgery. |
| first_indexed | 2024-12-13T19:39:26Z |
| format | Article |
| id | doaj.art-2a73dee6ef624816b3c6c86b482c16fe |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-13T19:39:26Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-2a73dee6ef624816b3c6c86b482c16fe2022-12-21T23:33:44ZengBMCBMC Surgery1471-24822021-10-012111910.1186/s12893-021-01364-3Splenic volume and splenic vein diameter are independent pre-operative risk factors of portal vein thrombosis after splenectomy: a retrospective cohort studyGuillaume Péré0Hubert Basselerie1Charlotte Maulat2Armando Pitocco3Pierrick Leblanc4Antoine Philis5Charles Henri Julio6Géraud Tuyeras7Etienne Buscail8Nicolas Carrere9Department of Digestive Surgery, Upper Gastro-Intestinal Tract Surgical Unit, University Hospital of ToulouseDepartment of Radiology, University Hospital of ToulouseDepartment of Digestive Surgery, Upper Gastro-Intestinal Tract Surgical Unit, University Hospital of ToulouseUnit of Epidemiology, Épidémiologie, Pôle Santé Publique et Médecine Sociale, Faculté de Médecine de Purpan, University of Toulouse III Paul SabatierDigestive Surgery, Joseph Ducuing Hospital, Hopital DucuingDepartment of Digestive Surgery, Upper Gastro-Intestinal Tract Surgical Unit, University Hospital of ToulouseDepartment of Digestive Surgery, Upper Gastro-Intestinal Tract Surgical Unit, University Hospital of ToulouseDepartment of Digestive Surgery, Upper Gastro-Intestinal Tract Surgical Unit, University Hospital of ToulouseDepartment of Digestive Surgery, Upper Gastro-Intestinal Tract Surgical Unit, University Hospital of ToulouseDepartment of Digestive Surgery, Upper Gastro-Intestinal Tract Surgical Unit, University Hospital of ToulouseAbstract Background Portal vein thrombosis (PVT) is a common complication following splenectomy. It affects between 5 and 55% of patients undergoing surgery with no clearly defined pre-operative risk factors. The aim of this study was to determine the pre-operative risk factors of PVT. Patients and method Single centre, retrospective study of data compiled for every consecutive patient who underwent splenectomy at Toulouse University Hospital between January 2009 and January 2019. Patients with pre- and post-surgical CT scans have been included. Results 149 out of 261 patients were enrolled in the study (59% were males, mean age 52 years). The indications for splenectomy were splenic trauma (30.9%), malignant haemopathy (26.8%) and immune thrombocytopenia (8.0%). Twenty-nine cases of PVT (19.5%) were diagnosed based on a post-operative CT scan performed on post-operative day (POD) 5. Univariate analysis identifies three main risk factors associated with post-operative PVT: estimated splenic weight exceeding 500 g with an OR of 8.72 95% CI (3.3–22.9), splenic vein diameter over 10 mm with an OR of 4.92 95% CI (2.1–11.8) and lymphoma with an OR of 7.39 (2.7–20.1). The role of splenic vein diameter with an OR of 3.03 95% CI (1.1–8.6), and splenic weight with an OR of 5.22 (1.8–15.2), as independent risk factors is confirmed by multivariate analysis. A screening test based on a POD 5 CT scan with one or two of these items present could indicate sensitivity of 86.2% and specificity of 86.7%. Conclusion This study suggests that pre-operative CT scan findings could predict post-operative PVT. A CT scan should be performed on POD 5 if a risk factor has been identified prior to surgery.https://doi.org/10.1186/s12893-021-01364-3SplenectomyPortal thrombosisPost-operative morbidityScreeningLymphomaSplenic vein |
| spellingShingle | Guillaume Péré Hubert Basselerie Charlotte Maulat Armando Pitocco Pierrick Leblanc Antoine Philis Charles Henri Julio Géraud Tuyeras Etienne Buscail Nicolas Carrere Splenic volume and splenic vein diameter are independent pre-operative risk factors of portal vein thrombosis after splenectomy: a retrospective cohort study BMC Surgery Splenectomy Portal thrombosis Post-operative morbidity Screening Lymphoma Splenic vein |
| title | Splenic volume and splenic vein diameter are independent pre-operative risk factors of portal vein thrombosis after splenectomy: a retrospective cohort study |
| title_full | Splenic volume and splenic vein diameter are independent pre-operative risk factors of portal vein thrombosis after splenectomy: a retrospective cohort study |
| title_fullStr | Splenic volume and splenic vein diameter are independent pre-operative risk factors of portal vein thrombosis after splenectomy: a retrospective cohort study |
| title_full_unstemmed | Splenic volume and splenic vein diameter are independent pre-operative risk factors of portal vein thrombosis after splenectomy: a retrospective cohort study |
| title_short | Splenic volume and splenic vein diameter are independent pre-operative risk factors of portal vein thrombosis after splenectomy: a retrospective cohort study |
| title_sort | splenic volume and splenic vein diameter are independent pre operative risk factors of portal vein thrombosis after splenectomy a retrospective cohort study |
| topic | Splenectomy Portal thrombosis Post-operative morbidity Screening Lymphoma Splenic vein |
| url | https://doi.org/10.1186/s12893-021-01364-3 |
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