Perioperative changes in quality of life in cirotic patients with portal splenopathy of surgical interest
DOI:
https://doi.org/10.52692/1857-0011.2024.2-79.22Keywords:
liver cirrhosis, portal splenopathy, splenectomy, quality of lifeAbstract
Portal splenopathy associated with severe symptomatic hypersplenism is a frequent complication of liver cirrhosis [1, 4], often of surgical interest. Laparoscopic splenectomy and esophagogastric devascularization has gained a prominent position in the field of portal hypertension. We evaluated 156 cirrhotic patients surgically assisted in the Clinic for portal splenopathy (year 2013-2023), laparoscopic (SPLL, n=64) or conventional open (SPLT, n=92) approach, associated in 69.9% of cases (109/159), with endoscopic variceal ligation (LVE). The clinical - endo - imaging characteristics of the patients and the quality of life, according to the chronic liver disease questionnaire (SF-LDQOL), were compared between the groups, depending on the surgical method. The results demonstrate that DVA+SPL has a positive impact on the quality of life (QoL-quality of life), constant 12-18 months after the operation. The lower QoL score, for the subdomains studied 3-5 years postoperatively, can be explained by the accumulation of risk factors dominated by liver depression and possible complications.
References
Boyer TD, Habib S. Big spleens and hypersplenism: fix it or forget it? Liver Int. 2015 May;35(5):1492-8.
Darii Eugeniu. Calitatea vieţii pacienţilor operaţi pentru ciroză hepatică în raport cu metodele de tratament chirurgical aplicate. Teză de doctorat, Chișinău, 2018, pag.14
Deng, Z. C., Jiang, W. Z., Chen, L. Laparoscopic VS. Open splenectomy and oesophagogastric devascularisation for liver cirrhosis and portal hypertension. International journal of surgery (London), 80, 79–83.
Qamar AA, Grace ND, Groszmann RJ, et al. Incidence, prevalence, and clinical significance of abnormal hematologic indices in compensated cirrhosis. Clin Gastroenterol Hepatol 2009;7:689–695.
Jiang GQ, Bai DS, Chen P, et al. Modified laparoscopic splenectomy and azygoportal disconnection combined with cell salvage is feasible and might reduce the need for blood transfusion. World J Gastroenterol. 2014 Dec 28;20(48):18420-6.
Yang L, Zhang Z, Zheng J, Kong J.. Long-term outcomes of oesophagogastric devascularization and splenectomy in patients with portal hypertension and liver cirrhosis. ANZ J Surg. 2020 Nov;90(11):2269- 2273.
Jenkinson C. Quality of life. The Editors of Encyclopaedia Britannica; 2023. Yamamoto, N., Okano, K., Oshima, M., Akamoto, S. Laparoscopic splenectomy for patients with liver cirrhosis. Surgery, 158(6), 1538–1544.
Kanwal F., Spiegel B., Hays D., Gralnek I. Prospective validation of the short form liver disease quality of life instrument. Aliment Pharmacol Ther., 2008; 28 (9):1088-101.
Hotineanu V., Cazacov V., Darii E. Norme metodologice privind analiza și evaluarea calității vieții pacienților hepatici chirurgical asistați. Îndrumări metodice. Chișinău, 2015, 41 p.
Nomura, Yoriko. Influence of splenectomy in patients with liver cirrhosis and hypersplenism. Hepatology Research, 2014, 44.10: E100-E109.
Журавель О. С. Гибридная технология хирургического лечения варикозного расширения вен пищевода, желудка гиперспленизма. Диссертация. Москва, 2022, 112 p.
Downloads
Published
License
Copyright (c) 2025 Bulletin of the Academy of Sciences of Moldova. Medical Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
