Impact of splenomegaly on portal hemodynamics and therapeutic implications of splenectomy in liver cirrhosis with portal hypertension: New insights into portal hypertensive splenopathy

2014 Fiscal Year Final Research Report

• Project/Area Number: 25893166
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Single-year Grants
• Research Field: Digestive surgery
• Research Institution: Kyushu University
• Principal Investigator: HIROFUMI Kawanaka 九州大学, 医学(系)研究科(研究院), 准教授 (10363334)
• Project Period (FY): 2013-08-30 – 2015-03-31
• Keywords: 脾門脈外科 / 門脈圧亢進症 / 脾機能亢進症 / 腹腔鏡下脾摘術

Outline of Final Research Achievements

We have shown here that splenomegaly in liver cirrhosis may actively contribute to the pathogenesis of portal hypertension by increasing intrahepatic vascular resistance and splanchnic flow. Splenectomy likely reduces portal venous pressure by two mechanisms: decreasing splanchnic blood flow and reducing intrahepatic vascular resistance by normalizing hepatic concentrations of ET-1 and NOx, leading to improvements in portal hypertension. splenomegaly has various deleterious effects including portal hemodynamics, fibrosis, and HCV infection. Thus, splenic dysfunction in liver cirrhosis with portal hypertension should be called portal hypertensive splenopathy rather than hypersplenism. Laparoscopic splenectomy can control portal hypertensive splenopathy less invasively and more safely, providing a feasible multidisciplinary treatment for patients with liver cirrhosis and portal hypertension, in combination with other modalities such as endoscopic treatment and IFN therapy.

Free Research Field

消化器外科