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Platelet safety range before splenectomy for hypersplenism : based on 244 cases of splenectomy in hepatolenticular degeneration patients

Journal Volume 84 - 2021
Issue Fasc.1 - Original articles
Author(s) S.T. Wang 1, H. Feng 2 3 #, H. Peng 3 4 #, L. Huang 2 3, F.H. Zhou 2 3, Q.S. Yu 2 3
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PAGES 51-56
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Affiliations:
(1) The First Affiliated Hospital of University of science and technology of China, Hefei, China
(2) The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
(3) Department of surgery, anhui academy of traditional Chinese medicine, Hefei, China
(4) Anhui university of traditional Chinese medicine, Hefei, China
(#) Contributed equally

Background and study aims: To investigate the safety and efficacy of splenectomy for hepatolenticular degeneration (HLD) patients with PLT less than 20 × 109/L.

Patients and methods: A total of 244 HLD patients with hypersplenism underwent splenectomy. According to the preoperative PLT values, the patients were divided into three groups : group A of 53 patients with PLT < 20 × 109/L ; group B of 92 patients with 20 × 109/L ≤ PLT ≤ 30 × 109/L ; group C of 99 patients with PLT > 30 × 109/L. General information including : blood cell counts, liver function , coagulation function 1 day before sugery and 1, 7, 14 days after surgery ; intraoperative blood loss ; operation time ; vital signs at the beginning, at 60 minutes and the end of the operation. Pressure and blood oxygen ; postoperative drainage ; postoperative complications and mortality.

Results: Blood cell counts, liver function, and coagulation function were improved after splenectomy in three groups (P<0.05) ; there was no significant difference in blood loss, operation time, vital signs during the operation, postoperative drainage, postoperative complications and mortality between three groups (P>0.05).

Conclusion: For HLD patients with hypersplenism, it is safe and effective to conduct splenectomy under PLT < 20 × 109/L.

Keywords: hepatolenticular degeneration, hypersplenism, platelet count, splenectomy.

The authors declare that they have no conflict of interest.
© Acta Gastro-Enterologica Belgica.
PMID 33639693