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Yang et al. Hepatoma Res 2020;6:37 Hepatoma Research
DOI: 10.20517/2394-5079.2020.09

Review Open Access

Risk factors of portal vein thrombosis after
splenectomy in patients with liver cirrhosis

Ze-long Yang , Ting Guo , Dong-Lie Zhu , Shi Zheng , Dan-Dan Han , Yong Chen 1
1
1
1
1
2
1 Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi, China.
2 Department of Obstetrics, Huaxi Hospital, Sichuan University, Cheng Du 610011, Si Chuan, China.
Correspondence to: Yong Chen, PhD, Chief Physician, Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military
Medical University, 127 West Changle Road, Xincheng District, Xi'an 710032, Shaanxi, China. E-mail: gdwkcy@fmmu.edu.cn
How to cite this article: Yang ZL, Guo T, Zhu DL, Zheng S, Han DD, Chen Y. Risk factors of portal vein thrombosis after
splenectomy in patients with liver cirrhosis. Hepatoma Res 2020;6:37. http://dx.doi.org/10.20517/2394-5079.2020.09
Received: 31 Jan 2020 First Decision: 13 Apr 2020 Revised: 4 May 2020 Accepted: 10 Jun 2020 Published: 10 Jul 2020
Academic Editor: Guang-Wen Cao, Guido Guenther Gerken Copy Editor: Cai-Hong Wang Production Editor: Tian Zhang

Abstract
Portal vein thrombosis (PVT) is a common complication after splenectomy, causing a possible negative impact on
the prognosis of patients with liver cirrhosis. However, the risk factors of PVT are not completely clear. Many factors
are related to the occurrence of postoperative PVT, such as hemodynamic changes, splenomegaly, splenectomy,
coagulation and anticoagulation disorder, liver cirrhosis, platelet count, D-dimer level, infection, inflammation, and
other factors.Hemodynamic changes are mainly caused by thicker portal and splenic vein diameters, larger spleen,
slower portal vein blood flow rate, lower portal vein pressure before and after surgery, etc. It is timely detection
and advanced prevention that really matter in reducing PVT incidence and improving patient prognosis. We
systematically reviewed the researches on the risk factors and therapies of PVTto provide useful information on a
comprehensive understanding for researchers.

Keywords: Liver cirrhosis, splenectomy, portal vein thrombosis, risk factors, treatments, prophylaxis

INTRODUCTION
Portal vein thrombosis (PVT) after splenectomy is a common postoperative complication, which has non-
[1]
specific clinical manifestation , including fever, anorexia, abdominal pain, abnormal liver function, elevated
C-reactive protein level, etc. As PVT progresses, complications can be worse and finally result in liver
[2-4]
function deterioration, intestinal infarction and even intestinal necrosis , making the mortality rate of PVT
[5]
even up to 10% . The incidence of PVT after splenectomy in patients with cirrhosis and portal hypertension
[6,7]
is reported to range 24% to 29% . For those who undergo splenectomy or accepted liver transplantation,
early prevention of PVT is quite important to improve prognosis, which requires a full understanding of the
risk factors of PVT. But so far, the risk factors of PVT still remain controversial.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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