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

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, splenectomy, platelet count.