血液疾患と輸血ジャーナル

概要

Effects of Preoperative Platelet Count on Blood Loss for Splenectomy with Esophagogastric Devascularization

Geng Bo, Piyush Kumar Mishra, Luo Chen, Yang Xian Mo, Ting Yan and Shiqiao Luo

Objective: To investigate whether low preoperative platelet count increased blood loss in splenectomy and esophagogastric devascularization for hepatitis B cirrhosis patients, and to discuss the necessity of prophylactic platelet transfusion in patients with platelet count less than 50 × 10⁹ /L.

Methods: 105 patients who received splenectomy from January 2008 to July 2014 were divided into three groups based on their preoperative platelet counts: <30 × 10⁹ /L (group 1), 30-50 × 10⁹ /L (group 2), >50 × 10⁹ /L (group 3). Their operation time, blood loss, postoperative platelet count of 1^st and 3^rd day, drainage volume, postoperative hospital stay and operation associated complications were compared between the 3 groups.

Results: Compared with patients in group 3, patients in group 1 and 2 experienced more blood loss, but the difference was not statistically significant (P>0.05). There were no significant differences among 3 groups in terms of operative time, postoperative drainage, postoperative hospital stay and operation-associated complications (P>0.05). Compared with preoperative results, PLT count increased significantly after the operation between the 3 groups (P<0.05).

Conclusion: It is safe to perform splenectomy and esophagogastric de-vascularization in hepatitis B cirrhosis patients with PLT count less than 50 × 10⁹ /L, and also in patients with platelet count lower than 30 × 10⁹ /L, it is not necessary to give prophylactic platelet transfusion until patient has any risk of bleeding.