The Effect Of Peri-esophagogastric Devascularization With Splenectomy On The Portal Venous Haemorheology Of The Portal Hypertension Patients

Background: Portal hypertension (PHT) is mainly caused by cirrhosis of liver led byhepatitis (most of them are Hepatitis B). Peri-esophagogastric devascularizationmainly operation that prevents and cures variceal bleeding induced by hepatitiscirrhotic portal hypertension and the accentuation of spleen function but the incidenceof PVT is high. The effect on this kind of operation has few reports. Understandingthe hemorheology of portal vein can help judge the prognosis and prevent thethrombus from forming.Objective: The effect of peri-esophagogastric devascularization with splenectomy onthe portal venous haemorheology of the portal hypertension patients and theconnection the changes between the preoperative portal venous haemorheology andpostoperative portal venous haemorheology with the formation of portal veinthrombosis were investigated.Methods: The49portal hypertension patients were operated withperi-esophagogastric devascularization with splenectomy(short for EGDS).The portalvenous blood was collected and determined before splenectomy. After EGDS, theportal venous blood was collected and determined again. The data of the preoperativeportal venous haemorheology and postoperative portal venous haemorheology hadbeen analyzed. The patients were divided into portal vein thrombosis (PVT) groupand group without portal vein thrombosis depended on whether they had PVT byiconography determination. The changes between the two groups of the preoperativeportal venous haemorheology and postoperative portal venous haemorheology hadalso been compared.Results:1. The markers related portal venous haemorheology of the49patients such as low shear rate of whole blood viscosity(η_l), plasma viscosity(PV), relative lowshear rate of whole blood viscosity, ESR, ESR-K, Erythrocyte Aggregation indices,the contents of D-dimer, PLT and so on were increased by some degrees and thedifference were significant(P <0.05or P <0.01). High shear rate of whole bloodviscosity(η_h), relative high shear rate of whole blood viscosity, HCT and Fib had nosignificant difference(P>0.05).PLT level after operation was higher than before andthe difference is significant(P <0.01).. the changes of Hb level and RBC level had nosignificance（P>0.05）.2. There were15patients with PVT and the incidence rate was30.61%within one year.3. The advancement of η_l, PV, relative η_l,ESR, ESR-K, ErythrocyteAggregation indices, the contents of D-dimer and PLT were higher compared with thegroup without thrombosis and the difference is significant(P <0.01)Conclusion:1. The Peri-esophagogastric devascularization with splenectomy hadsignificant effect on the portal venous haemorheology of the portal hypertensionpatients and the main manifest were the increasing of low shear rate of whole bloodviscosity, plasma viscosity, the contents of D-dimer and PLT.2. The portal hypertension patients with postoperative higheradvancement level of these haemorheology markers had more risk to have PVT canhelp judge the prognosis and prevent the thrombus from forming.