Partial splenectomy may prevent portal vein thrombosis after hassab surgery in patients with megalosplenia

Objective To study whether portal vein thrombosis can be prevented by partial splenectomy combined with portoazygos devascularization, by preserving the integrity of the blood flow of the inferior splenic vessels. Methods 156 patients with portal hypertension and megalosplenia were divided into two groups. 62 patients in group A who underwent partial splenectomy and 94 patients in group B who underwent total splenectomy. The postoperative complications, levels of WBC and PLT, volumes of residual spleen, hepatic vein pressure gradient (HVPG), and prevalence of portal vein thrombosis between the two groups were compared. Results The surgery time of group A was slightly higher than group B [(189.0±38.5) vs. (128.0±36.3) min, P 0.05). The elevation in Leucocyte after operation of the two groups were the same, peaking on day 3. The platelet count of group A increased more gently than group B (2 weeks vs 1 week), and its peak was closer to the normal threshold (P 0.05). Conclusion Subtotal splenectomy combined with pericardial devascularization in patients with portal hypertension and megalosplenia preserved the blood flow of the subsplenic polar vessels and reduced the incidence of portal vein thrombosis. Key words: Portal hypertension; Portoazygos devascularization; Total splenectomy; Portal vein thrombosis; Hassab's procedure