Splenectomy with Portoazygous Disconnection for Correction of Systemic Hemodynamic Disorders in Hepatic Cirrhosis Patients with Portal Hypertension: A Prospective Single-Center Cohort Study
Objective. To investigate the effect of splenectomy for correction of systemic hemodynamic disorders in hepatic cirrhosis patients with portal hypertension. Methods. Hepatic cirrhosis patients with portal hypertension were enrolled from April 2015 to July 2018. Systemic hemodynamic parameters (heart...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2020/8893119 |
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| author | Dao-Bing Zeng Liang Di Qing-Liang Guo Jing Ding Xiao-Fei Zhao Shi-Chun Lu |
| author_facet | Dao-Bing Zeng Liang Di Qing-Liang Guo Jing Ding Xiao-Fei Zhao Shi-Chun Lu |
| author_sort | Dao-Bing Zeng |
| collection | DOAJ |
| description | Objective. To investigate the effect of splenectomy for correction of systemic hemodynamic disorders in hepatic cirrhosis patients with portal hypertension. Methods. Hepatic cirrhosis patients with portal hypertension were enrolled from April 2015 to July 2018. Systemic hemodynamic parameters (heart rate, mean arterial pressure (MAP), cardiac output, and total peripheral vascular resistance (TPR)) were prospectively measured at baseline and 1 week, 1, 3, and 6 months, and 1, 2, and 3 years postoperatively. Paired analysis was conducted. Results. Sixty-nine patients were eligible, and 55 (79.7%) cases had a history of upper gastrointestinal bleeding. Child–Pugh classification was grade A in 41 (59.4%) cases, grade B in 26 (37.7%) cases, and grade C in 2 (2.9%) cases. The heart rate was significantly higher at 1 week postoperatively versus the baseline (P<0.001). Meanwhile, the heart rate was significantly lower from 3 months to 2 years postoperatively versus the baseline (P<0.05). The MAP was significantly higher at 6 months to 2 years postoperatively versus the baseline (P<0.05). At 1 month postoperatively and 6 months to 2 years, the cardiac output was significantly lower versus the baseline (P<0.05). At 1 month postoperatively and 6 months to 2 years, the TPR was significantly higher versus the baseline (P<0.05). Conclusion. Splenectomy corrects systemic hemodynamic disorder in hepatic cirrhosis patients with portal hypertension, and the effect is rapid and durable. |
| format | Article |
| id | doaj-art-115ec65fb79d4ad4b53960c63bb1b469 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-115ec65fb79d4ad4b53960c63bb1b4692025-02-03T01:00:12ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972020-01-01202010.1155/2020/88931198893119Splenectomy with Portoazygous Disconnection for Correction of Systemic Hemodynamic Disorders in Hepatic Cirrhosis Patients with Portal Hypertension: A Prospective Single-Center Cohort StudyDao-Bing Zeng0Liang Di1Qing-Liang Guo2Jing Ding3Xiao-Fei Zhao4Shi-Chun Lu5General Surgery Department, Beijing Youan Hospital, Capital Medical University, Beijing 100069, ChinaGeneral Surgery Department, Beijing Youan Hospital, Capital Medical University, Beijing 100069, ChinaGeneral Surgery Department, Beijing Youan Hospital, Capital Medical University, Beijing 100069, ChinaGeneral Surgery Department, Beijing Youan Hospital, Capital Medical University, Beijing 100069, ChinaGeneral Surgery Department, Beijing Youan Hospital, Capital Medical University, Beijing 100069, ChinaInstitute and Hospital of Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing 100853, ChinaObjective. To investigate the effect of splenectomy for correction of systemic hemodynamic disorders in hepatic cirrhosis patients with portal hypertension. Methods. Hepatic cirrhosis patients with portal hypertension were enrolled from April 2015 to July 2018. Systemic hemodynamic parameters (heart rate, mean arterial pressure (MAP), cardiac output, and total peripheral vascular resistance (TPR)) were prospectively measured at baseline and 1 week, 1, 3, and 6 months, and 1, 2, and 3 years postoperatively. Paired analysis was conducted. Results. Sixty-nine patients were eligible, and 55 (79.7%) cases had a history of upper gastrointestinal bleeding. Child–Pugh classification was grade A in 41 (59.4%) cases, grade B in 26 (37.7%) cases, and grade C in 2 (2.9%) cases. The heart rate was significantly higher at 1 week postoperatively versus the baseline (P<0.001). Meanwhile, the heart rate was significantly lower from 3 months to 2 years postoperatively versus the baseline (P<0.05). The MAP was significantly higher at 6 months to 2 years postoperatively versus the baseline (P<0.05). At 1 month postoperatively and 6 months to 2 years, the cardiac output was significantly lower versus the baseline (P<0.05). At 1 month postoperatively and 6 months to 2 years, the TPR was significantly higher versus the baseline (P<0.05). Conclusion. Splenectomy corrects systemic hemodynamic disorder in hepatic cirrhosis patients with portal hypertension, and the effect is rapid and durable.http://dx.doi.org/10.1155/2020/8893119 |
| spellingShingle | Dao-Bing Zeng Liang Di Qing-Liang Guo Jing Ding Xiao-Fei Zhao Shi-Chun Lu Splenectomy with Portoazygous Disconnection for Correction of Systemic Hemodynamic Disorders in Hepatic Cirrhosis Patients with Portal Hypertension: A Prospective Single-Center Cohort Study Canadian Journal of Gastroenterology and Hepatology |
| title | Splenectomy with Portoazygous Disconnection for Correction of Systemic Hemodynamic Disorders in Hepatic Cirrhosis Patients with Portal Hypertension: A Prospective Single-Center Cohort Study |
| title_full | Splenectomy with Portoazygous Disconnection for Correction of Systemic Hemodynamic Disorders in Hepatic Cirrhosis Patients with Portal Hypertension: A Prospective Single-Center Cohort Study |
| title_fullStr | Splenectomy with Portoazygous Disconnection for Correction of Systemic Hemodynamic Disorders in Hepatic Cirrhosis Patients with Portal Hypertension: A Prospective Single-Center Cohort Study |
| title_full_unstemmed | Splenectomy with Portoazygous Disconnection for Correction of Systemic Hemodynamic Disorders in Hepatic Cirrhosis Patients with Portal Hypertension: A Prospective Single-Center Cohort Study |
| title_short | Splenectomy with Portoazygous Disconnection for Correction of Systemic Hemodynamic Disorders in Hepatic Cirrhosis Patients with Portal Hypertension: A Prospective Single-Center Cohort Study |
| title_sort | splenectomy with portoazygous disconnection for correction of systemic hemodynamic disorders in hepatic cirrhosis patients with portal hypertension a prospective single center cohort study |
| url | http://dx.doi.org/10.1155/2020/8893119 |
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