Журнал болезней крови и переливания крови

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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.