Thrombocytopenia in portal hypertension syndrome: risk of bleeding, role of shunting surgery and consequences of splenectomy

We investigated the efficacy of portosystemic shunting and splenectomy performed for correction of portal hypertension and concomitant thrombocytopenia. Inadequate portosystemic gradient depression and thrombocytosis formation after splenectomy are demonstrated. The worst results of portosystemic shunting in patients undergoing splenectomy are established. Using the linear regression analysis we demonstrated the association of the portosystemic gradient level and platelet count in patients with extrahepatic portal hypertension (R2=0.577, pR2=0.069, p=0.343). We conclude that thrombocytopenia is non-invasive predictor of variceal bleeding in case of extrahepatic portal vein occlusion and that splenectomy is unreasonable for hypersplenism treatment.