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- Title
Portal vein thrombosis after laparoscopic splenectomy in benign hematologic diseases.
- Authors
Ruiz-Tovar, Jaime; De Oteyza, Joaquín Pérez; Sánchez, Javier Blázquez; Velardo, Asunción Aguilera; Blanco, Roberto Rojo; Guirao, Maria Vicenta Collado; Villanueva, Augusto García; Pérez de Oteyza, Joaquín; Blázquez Sánchez, Javier; Aguilera Velardo, Asunción; Rojo Blanco, Roberto; Collado Guirao, Maria Vicenta; García Villanueva, Augusto
- Abstract
<bold>Introduction: </bold>Portal vein thrombosis is an unfrequent, but potentially deadly, complication of the laparoscopic splenectomy procedure. The laparoscopic approach has shortened the duration of hospital stay; portal vein thrombosis may appear after the patient has left the hospital, determining a later diagnosis. Because of the mild, nonspecific symptoms, the diagnosis can even be missed and only achieved when chronic complications take place. <bold>Objectives: </bold>In this study, we aimed to determine the appearance of portal vein thrombosis in a consecutive series of patients who underwent laparoscopic splenectomy by performing a contrast-enhanced computed tomography (CT) scan postoperatively. <bold>Materials and Methods: </bold>A transversal study was established, performing in 2005 a contrast-enhanced CT scan on 20 patients who underwent laparoscopic splenectomy between 1999 and 2005 at Ramón y Cajal University Hospital (Madrid, Spain). The presence of thrombosis in the splenoportomesenteric axis was investigated. <bold>Results: </bold>Two (2) cases (10%) of portal vein thrombosis were detected: 1 symptomatic case, 7 days after surgery, was treated with anticoagulation, resulting in the disappearance of the thrombus in a new CT scan 6 months later; the second case was asymptomatic and was discovered during the performance of this study. <bold>Conclusions: </bold>The contrast-enhanced CT scan shows the best accuracy for the diagnosis of portal vein thrombosis, and it must be performed when any clinical manifestation appear; also, it must still be determined if a contrast-enhanced CT scan should be systematically performed in high-risk thromboembolic patients. An ultrasound Doppler may present many diagnostic errors. It is probably advisable to prolong the antithromboembolic prophylaxis.
- Subjects
PORTAL vein; THROMBOSIS; LAPAROSCOPY; SPLENECTOMY; BLOOD diseases
- Publication
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2007, Vol 17, Issue 4, p448
- ISSN
1092-6429
- Publication type
journal article
- DOI
10.1089/lap.2006.0203