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Surgical Endoscopy

Published in:

01-07-2004 | Original article

Thrombosis in the portal venous system after elective laparoscopic splenectomy

Authors: A. Pietrabissa, C. Moretto, G. Antonelli, L. Morelli, E. Marciano, F. Mosca

Published in: Surgical Endoscopy | Issue 7/2004

Abstract

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 prophyaxis.

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Title: Thrombosis in the portal venous system after elective laparoscopic splenectomy
Authors: A. Pietrabissa
C. Moretto
G. Antonelli
L. Morelli
E. Marciano
F. Mosca
Publication date: 01-07-2004
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 7/2004
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-003-9284-5

At a glance: The STEP trials

Springer Medicine

Thrombosis in the portal venous system after elective laparoscopic splenectomy

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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