Introduction
Material and methods
Patients
Interventional and surgical procedures
Intraoperative and postoperative outcomes
Statistical analysis
Results
Demographic and clinical characteristics
Total (N = 59) | Splenectomy (N = 41) | SAE + splenectomy (N= 18) | P value | |
---|---|---|---|---|
Age (years), mean (SD) | 44.7 (12.4) | 45.0 (13.4) | 44.2 (10.2) | 0.825 |
Sex (female/male) | 16/43 | 12/29 | 4/14 | 0.753 |
BMI (kg/m2), mean (SD) | 21.3 (3.2) | 21.1 (3.1) | 21.7 (3.4) | 0.524 |
ASA score, n (%) | ||||
2 | 43 (72.8) | 34 (82.9) | 9 (50.0) | |
3 | 16 (27.1) | 7 (17.1) | 9 (50.0) | 0.009* |
Prior abdominal surgery, n (%) | 22 (37.3) | 14 (34.1) | 8 (44.4) | 0.451 |
Pathological backgrounds, n (%) | ||||
Pancreatic pseudocyst | 33 (55.9) | 22 (53.7) | 11 (61.1) | 0.595 |
Pancreatic abscess | 9 (15.3) | 7 (17.1) | 2 (11.1) | 0.708 |
Acute pancreatitis | 2 (3.4) | 1 (2.4) | 1 (5.6) | 0.521 |
Chronic pancreatitis | 14 (23.7) | 11 (26.8) | 3 (16.7) | 0.516 |
Gastric ulcer | 1 (1.7) | 0 | 1 (5.6) | 0.305 |
Prior pancreatitis attack (times), median (IQR) | 2 (1–4) | 2 (1–4) | 2 (1–2) | 0.258 |
Albumin (g/l), mean (SD) | 38.4 (6.3) | 39.1 (5.8) | 36.8 (7.2) | 0.214 |
PT (s), mean (SD) | 12.4 (1.2) | 12.4 (1.1) | 12.4 (1.5) | 0.902 |
APTT (s), mean (SD) | 29.3 (3.5) | 29.8 (3.1) | 28.2 (4.1) | 0.097 |
PLT count (10^9/l), median (IQR) | 142 (110–187) | 152 (115–198) | 136.5 (91.25–169.75) | 0.344 |
Spleen diameter (cm), median (SD) | 12.8 (12.2–13.4) | 12.7 (12.1–13.4) | 12.9 (11.5–14.2) | 0.294 |
Comorbidity | ||||
Diabetes mellitus, n (%) | 16 (27.1) | 9 (22.0) | 7 (38.8) | 0.212 |
Hypertension, n (%) | 6 (10.2) | 5 (12.2) | 1 (5.6) | 0.656 |
Hyperlipemia, n (%) | 10 (16.9) | 6 (14.6) | 4 (22.2) | 0.475 |
Intraoperative and postoperative outcomes
Total (N = 59) | Splenectomy (N = 41) | SAE + splenectomy (N = 18) | P value | |
---|---|---|---|---|
Estimated blood loss (ml), median (IQR) | 502.1 (392.1–937.5) | 637.0 (416.5–1109.9) | 420.3 (278.1–620.1) | 0.041* |
Intraoperative transfusion (ml), median (IQR) | 0 (0–600) | 0 (0–600) | 500 (0–600) | 0.171 |
Operation time (min), mean (IQR) | 160 (130–200) | 174 (145–212) | 141.5 (120–166.25) | 0.012* |
Distal pancreatectomy, n (%) | 52 (88.1) | 39 (95.1) | 13 (72.2) | 0.023* |
Pseudocyst resection, n (%) | 2 (3.4) | 1 (2.4) | 1 (5.6) | 0.521 |
Pseudocyst drainage, n (%) | 31 (52.5) | 21 (51.2) | 10 (52.6) | 0.759 |
Abscess drainage, n (%) | 9 (15.3) | 7 (17.1) | 2 (10.5) | 0.708 |
Complications, n (%) | ||||
No POPF | 46 (78.0) | 34 (82.9) | 12 (66.7) | |
Biochemical POPF | 12 (20.3) | 7 (17.1) | 5 (27.8) | |
POPF B | 1 (1.7) | 0 | 1 (5.6) | 0.146 |
Bleeding | 5 (8.5) | 4 (9.8) | 1 (5.6) | 1.000 |
Thromboembolism | 3 (5.1) | 2 (4.9) | 1 (5.6) | 1.000 |
Pleural effusion | 2 (3.4) | 1 (2.4) | 1 (5.6) | 0.521 |
Infected abdominal fluid collection | 7 (11.9) | 4 (9.8) | 3 (16.7) | 0.664 |
Noninfected abdominal fluid collection | 2 (3.4) | 2 (4.9) | 0 | 1.000 |
Adhesive ileus | 2 (3.4) | 1 (2.4) | 1 (2.4) | 0.521 |
Total LOS (days), median (IQR) | 13 (9–18) | 13 (10–17) | 12.5 (9–19) | 0.791 |
Postoperative LOS (days), median (IQR) | 6 (6–8) | 6 (6–8) | 8(5–10.3) | 0.159 |
Total costa (RMB), median (IQR) | 71,167.4 (58,779.3–86,028.7) | 69,358.9 (57,795.6–76,642.4) | 85,721.2 (70,800.5–104,598.3) | 0.002* |
Surgery cost (RMB), mean (SD) | 23,381.7 (6278.5) | 23,604.6 (5784.4) | 22,874.0 (7441.3) | 0.684 |
Interventional therapy cost (RMB), mean (IQR) | NS | NS | 17,774.5 (13,014.7–21,368.0) | NS |
Risk factors for excessive intraoperative blood loss in patients with sinistral portal hypertension who underwent splenectomy
Univariate analysis | Multivariate analysis | |||
---|---|---|---|---|
Odds ratio (95% CI) | P | Odds ratio (95% CI) | P | |
Age | 0.991 (0.950–1.034) | 0.666 | ||
Sex (female) | 1.742 (0.516–5.878) | 0.371 | ||
BMI | 1.119 (0.947–1.323) | 0.187 | ||
ASA score | 1.190 (0.372–3.801) | 0.770 | ||
Prior abdominal surgery | 2.500 (0.844–7.401) | 0.098* | 1.331 (0.302–5.655) | 0.697 |
Prior pancreatitis attack | 0.978 (0.883–1.084) | 0.676 | ||
Prior pancreatic pseudocyst/abscess | 8.250 (1.674–40.652) | 0.010* | 6.734 (1.411–48.923) | 0.015* |
Albumin | 0.905 (0.824–0.993) | 0.035* | 1.016 (0.877–1.190) | 0.828 |
PT | 1.730 (1.065–2.811) | 0.027* | 1.294 (0.656–2.807) | 0.459 |
APTT | 1.173 (0.992–1.387) | 0.061* | 1.017 (0.821–1.269) | 0.876 |
PLT count | 1.002 (0.996–1.008) | 0.468 | ||
Spleen diameter | 0.945 (0.745–1.198) | 0.639 | ||
Operation time | 1.001(0.991–1.010) | 0.886 | ||
Distal pancreatectomy | 4.759 (0.534–42.375) | 0.162 | ||
Intraoperative transfusion | 1.003 (1.001–1.005) | 0.002 | 1.003 (1.000–1.007) | 0.017* |
Preoperative SAE | 0.300 (0.084–1.067) | 0.063* | 0.088 (0.008–0.495) | 0.004* |
Risk factors for prolonged operation time in patients with sinistral portal hypertension who underwent splenectomy
Univariate analysis | Multivariate analysis | |||
---|---|---|---|---|
Odds ratio (95% CI) | P | Odds ratio (95% CI) | P | |
Age | 1.024 (0.980–1.070) | 0.286 | ||
Sex (female) | 0.762 (0.238–2.443) | 0.647 | ||
BMI | 1.001 (0.850–1.180) | 0.987 | ||
ASA score | 1.867 (0.583–5.975) | 0.293 | ||
Prior abdominal surgery | 2.836 (0.948–8.487) | 0.062* | 3.370 (1.021–12.409) | 0.046* |
Prior pancreatitis attack | 1.083 (0.967–1.212) | 0.170 | ||
Prior pancreatic pseudocyst/abscess | 4.242 (1.061–16.968) | 0.041* | 4.559 (1.215–21.468) | 0.024* |
Spleen diameter | 0.905 (0.710–1.153) | 0.418 | ||
Distal pancreatectomy | 1.694 (0.300–9.561) | 0.551 | ||
Intraoperative transfusion | 1.001 (1.000–1.002) | 0.192 | ||
Preoperative SAE | 0.210 (0.053–0.837) | 0.027* | 0.154 (0.031–0.586) | 0.005* |