Splenectomy and azygoportal disconnection decreases the risk of hepatocellular carcinoma for cirrhosis patients with portal hypertension bleeding: a 10-year retrospective follow-up study based on the inverse probability of treatment weighting method

Background Liver cirrhosis is the highest risk factor for hepatocellular carcinoma (HCC) worldwide. However, etiological therapy is the only option in cirrhosis patients to decrease the HCC risk. The aim of this study was to explore whether laparoscopic splenectomy and azygoportal disconnection (LSD...

Full description

Saved in:
Bibliographic Details
Published in:Journal of gastroenterology 2023-05, Vol.58 (5), p.503-512
Main Authors: Gao, Tian-Ming, Zhou, Jie, Xiang, Xiao-Xing, Jin, Sheng-Jie, Qian, Jian-Jun, Zhang, Chi, Zhou, Bao-Huan, Tang, Hua, Bai, Dou-Sheng, Jiang, Guo-Qing
Format: Article
Language:English
Subjects:
Abdominal Surgery
Biliary Tract
Bleeding
Carcinoma, Hepatocellular - etiology
Carcinoma, Hepatocellular - surgery
Care and treatment
Cirrhosis
Colorectal Surgery
Endoscopy
Esophageal and Gastric Varices - etiology
Esophageal and Gastric Varices - surgery
Follow-Up Studies
Gastroenterology
Gastrointestinal Hemorrhage - etiology
Gastrointestinal Hemorrhage - prevention & control
Health aspects
Hepatocellular carcinoma
Hepatology
Hepatoma
Humans
Hypersplenism
Hypertension
Hypertension, Portal - complications
Hypertension, Portal - surgery
Laparoscopy
Liver
Liver cancer
Liver cirrhosis
Liver Cirrhosis - complications
Liver Neoplasms - complications
Liver Neoplasms - surgery
Medicine
Medicine & Public Health
Methods
Organ donors
Original Article—Liver
Pancreas
Portal hypertension
Regression analysis
Retrospective Studies
Risk Factors
Splenectomy
Splenectomy - adverse effects
Splenectomy - methods
Surgery
Surgical Oncology
Survival
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Liver cirrhosis is the highest risk factor for hepatocellular carcinoma (HCC) worldwide. However, etiological therapy is the only option in cirrhosis patients to decrease the HCC risk. The aim of this study was to explore whether laparoscopic splenectomy and azygoportal disconnection (LSD) decreases the risk of HCC for patients with cirrhotic portal hypertension (CPH). Methods Between April 2012 and April 2021, we identified 595 CPH patients in our hepatobiliary pancreatic center who were diagnosed with gastroesophageal variceal bleeding and secondary hypersplenism, and performed a 10-year retrospective follow-up. Inverse probability of treatment weighting (IPTW) was used to adjust for potential confounders, weighted Kaplan–Meier curves and logistic regression to estimate survival and risk differences. Results According to the method of therapy, patients were divided into LSD ( n  = 345) and endoscopic therapy (ET; n  = 250) groups. Kaplan–Meier analysis revealed that patients who underwent LSD had higher survival benefit with those who underwent ET ( P  
ISSN:0944-1174
1435-5922
DOI:10.1007/s00535-023-01982-z