Abstract: Objective
To investigate the risk factors for recurrent gastrointestinal hemorrhage after splenectomy plus pericardial devascularization for patients with portal hypertension.
Methods
The clinical data of 117 patients with HBV induced liver cirrhosis who received splenectomy plus pericardial devascularization at the First Affiliated Hospital of Xi′an Jiaotong University from January 2008 to June 2011 were retrospectively analyzed. There were 22 patients had gastrointestinal bleeding postoperatively. Factors associated with postoperative gastrointestinal re bleeding were analyzed to screen out the related risk factors. Univariate and multivariate analysis were done by chi square test and Logistic regression model, respectively.
Results
All the patients were followed up for 20.6 -61.7 months after the operation, and the incidence of postoperative gastrointestinal re bleeding was 18.80%(22/117). The results of univariate analysis showed that HBV infection, preoperative level of aspartate aminotransferase (AST), degree of esophagogastric varices, platelet count on postoperative day 7 and postoperative portal vein thrombosis were risk factors of postoperative gastrointestinal re bleeding ( OR=4.758, 5.560, 3.616, P <0.05).
Conclusions
History of HBV infection more than 10 years, severe esophageal varices (3rd degree) and postoperative portal vein thrombosis are the independent risk factors of gastrointestinal bleeding after splenectomy plus pericardial devascularization. Meticulous monitoring of individuals with the risk factors are warranted in order to ameliorate the prognosis.