The analysis of clinical and laboratory characteristics in patients with liver cirrhosis after surgical treatment by azygo-portal devascularisation and splenectomy

Abstract

Introduction: Liver cirrhosis is one of the great problems of gastroenterological pathology, as well as a public health problem because of the high incidence, chronicity, severity of complications and high costs involved in the care of these patients. Approximately 77% of patients with hepatic cirrhosis have a severe hipersplenic syndrome with forecast reserved. Surgical approach has proven to be very effective in solving the severe hipersplenic syndrome. Purpose and objectives: To analyze the clinical and laboratory characteristics in patients with cirrhosis of different etiology within 6 months to 3 years after surgery by azygo-portal devascularisation and splenectomy. Materials and methods: We studied retrospective 47 patients with liver cirrhosis hospitalized in the department of hepatology and hepato-biliary surgery departments of IMSP - SCR, from 2010 to 2013, undergoing surgical treatment of solving the portal-hypertensive splenopathy. The diagnosis was confirmed clinically, biologically and imagistically. Clinical and laboratory results were analyzed using patient’s clinical observation sheets from the archive of IMSP-Republican Hospital using Microsoft Office Excel 2007 and SPSS v. 17.0 programs. Results: It has been found: > a significant improvement of the asthenic, hemorrhagic, abdominal pain and dyspeptic syndromes; > a statistically significant improvement for platelets, leukocytes, erythrocytes and an improvement of the hepatocellular insufficiency syndrome characterized by prothrombin and fibrinogen; > many of the patients who gather the score for Child-Pugh class B before the surgery passed in class A after it, which shows an improvement in the clinical and paraclinical features; > a significant decrease in the incidence of upper gastrointestinal bleeding (50% before and 10% after) and its severity after surgery. Conclusions: This study showed the benefits of surgery by azygo-portal devascularisation and splenectomy in improving the clinical and paraclinical manifestations in patients with liver cirrhosis with portal hypertension.