Effects of Preoperative Platelet Count on Blood Loss for Splenectomy with Esophagogastric Devascularization

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: 50 × 109 /L (group 3). Their operation time, blood loss, postoperative platelet count of 1st and 3rd 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.