Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jun 14, 2010; 16(22): 2801-2805
Published online Jun 14, 2010. doi: 10.3748/wjg.v16.i22.2801
Post-gastrectomy spleen enlargement and esophageal varices: Distal vs total gastrectomy
Takatsugu Oida, Kenji Mimatsu, Hisao Kano, Atsushi Kawasaki, Youichi Kuboi, Nobutada Fukino, Sadao Amano
Takatsugu Oida, Kenji Mimatsu, Hisao Kano, Atsushi Kawasaki, Youichi Kuboi, Nobutada Fukino, Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Yamashita-cho, Naka-ku, Yokohama 231-8553, Japan
Sadao Amano, Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchi, kami-cho, Itabashi-ku, Tokyo 173-0023, Japan
Author contributions: Oida T, Mimatsu K, Kano H, Kawasaki A, Kuboi Y and Fukino N carried out the operation and were consultants overseeing the patient’s care; Oida T wrote the manuscript; Amano S drafted the manuscript and revised it critically.
Correspondence to: Takatsugu Oida, MD, PhD, Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Yamashita-cho, Naka-ku, Yokohama 231-8553, Japan. ooida.takatsugu@yokochu.jp
Telephone: +81-45-6411921 Fax: +81-45-6719871
Received: January 28, 2010
Revised: March 5, 2010
Accepted: March 12, 2010
Published online: June 14, 2010
Abstract

AIM: To study the relationship between platelet count-to-spleen diameter ratio and post-gastrectomy esophageal varices (EVs) development in patients without liver cirrhosis or hepatitis.

METHODS: We retrospectively studied 92 patients who underwent gastrectomy. They were divided into 2 groups on the basis of the surgical treatment: the distal gastrectomy (DG) group and total gastrectomy (TG) group. The incidence of EVs was determined and postoperative platelet counts, spleen diameters, and platelet count-to-spleen diameter ratios were compared between the 2 groups.

RESULTS: EVs were not detected during the first 6 mo after surgery in either group; however, at 12 mo after surgery, EVs were detected in 2 patients (3%) in the DG group and in 1 patient (3.6%) in the TG group; their mean platelet count-to-spleen diameter ratio was 2628 ± 409, and 2604 ± 360, respectively.

CONCLUSION: Endoscopy should be performed to detect EVs when the platelet count-to-spleen diameter ratio is < 2600.

Keywords: Spleen enlargement; Esophageal varices; Platelet count; Distal gastrectomy; Total gastrectomy