The reason and treatment of portal vein thrombosis in patients with portal hypertension postoperation

Objective To investigate reason and the management of portal vein thrombosis in patients with portal hypertension postoperatively. Methods 329 patients with portal hypertension in liver cirrhosis who had splenectomy was reviewed from 1992 to 2001.In whom 43 (13.1%) patients with portal vein thrombosis postoperative were analyzed. Results In these patients,except 1 died for portal vein phlebitis,all patients were recovered. There are 138 patients who underwent splenectomy or splenectomy and devascularization,26(18.8%) of them had thrombosis. 191 patients underwent splenectomy and portacaval or portasplenic shut,17 (8.9%) of them had thrombosis. The data of these two groups have significant difference(χ 2=8.44, P 0.01). Conclusions Thrombocytosis postsplenectomy as well as the changes of portal hemodynamics is the main reason of portal vein thrombosis. Portal vein thrombosis is also in association with the operative ways. Operation standardization,dynamic examining platelet count, routine color ultrasonography examining and early anticoagulation therapy are the effective methods in preventing and managing portal thrombosis postoperation for portal hypertension.