Objective To investigate the changes of the liver volume in patients with cirrhotic portal hypertension after splenectomy combined with devascularization,and to analyze the related causes.Methods Clinical and imaging data of 94 patients with cirrhotic portal hypertension who underwent surgical treatment at the People's Hospital of Ningxia Hui Autonomous Region between January 2014 and May 2024 were included and analyzed before and after surgery.The cohort comprised 61 males and 33 females,aged(47±12)years.The preoperative and postoperative liver volumes were compared,and the patients were divided into two groups based on the changes in postoperative liver volume:the volume increase group(n=51)and the volume decrease group(n=43).Clinical data were collected including liver volume,hepatic artery diame-ter,spontaneous portosystemic shunt(SPSS),portal vein thrombosis(PVT),and hepatic artery dilation.Results Compared with the volume decrease group,the postoperative liver volume[(1 157±237)cm3 vs.(977±271)cm3]and incidence of hepatic artery dilation[92.2％(47/51)vs.67.4％(29/43)]in the volume increase group both increased,while the incidence of newly formed SPSS[3.9％(2/51)vs.18.6％(8/43)]and PVT[5.9％(3/51)vs.34.9％(15/43)]after surgery both decreased,and the differences were statistically significant(all P＜0.05).After splenectomy combined with devascularization,patients with decreased liver volume exhibited aggravated conditions of serrated or wavy changes at the edge of the liver and widening of liver fissures,while patients with increased liver volume had significant reduction or disappearance of serrated or wavy changes at the edge of the liver and narrowing of liver fission.Conclusion Splenectomy combined with devascularization can increase the postoperative liver volume in patients with cir-rhotic portal hypertension,and decrease in postoperative liver volume may be related to the occurrence of SPSS and PVT.
Liver cirrhosisPortal hypertensionSplenectomy combined with devascularizationLiver volumePortal vein thrombosis
维普
万方数据
