Thrombosis in the portal venous system after elective laparoscopic splenectomy

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

Research output: Contribution to journalArticle

Abstract

Background: The occurrence of thrombosis in the portal system is an underappreciated complication of splenectomy. Presenting symptoms are usually mild and non-specific. 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.

Original languageEnglish
Pages (from-to)1140-1143
Number of pages4
JournalSurgical Endoscopy and Other Interventional Techniques
Volume18
Issue number7
Publication statusPublished - Jul 2004

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Keywords

  • Color Doppler ultrasonography
  • Laparoscopic splenectomy
  • Platelet count
  • Portal system
  • Spleen
  • Thrombosis

ASJC Scopus subject areas

  • Surgery

Cite this

Pietrabissa, A., Moretto, C., Antonelli, G., Morelli, L., Marciano, E., & Mosca, F. (2004). Thrombosis in the portal venous system after elective laparoscopic splenectomy. Surgical Endoscopy and Other Interventional Techniques, 18(7), 1140-1143.