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Laparoscopic splenectomy with interferon therapy in 100 hepatitis-C-virus-cirrhotic patients with hypersplenism and thrombocytopenia.

AbstractBACKGROUND AND AIM:
We intended to determine whether laparoscopic splenectomy (Lap-Sp) contributes to treatment with interferon therapy in hepatitis C virus (HCV)-cirrhotic patients with thrombocytopenia caused by hypersplenism.
METHODS:
From December 2004 to August 2008, 100 cirrhotic patients (54 men and 46 women) underwent Lap-Sp for a clinical application of interferon therapy. All the patients were Child-Pugh class A or B with thrombocytopenia (average platelet count, 56 × 10(3) /mm(3)). The HCV genotype was type 1 in 80 patients and type 2 in 20 patients.
RESULTS:
Pure laparoscopic or hand-assisted laparoscopy was performed in 78 and 22 patients, respectively, without mortality. Conversion to open surgery was not required in any of the patients. The platelet counts improved (mean platelet count 172 × 10(3) /mm(3) 1 month after surgery) and interferon (IFN) therapy was started in 97 patients. In this study period, 36 patients obtained a sustained virologic response. Eight patients discontinued IFN therapy because of depression, neutropenia or other reasons.
CONCLUSIONS:
Lap-Sp permits most patients with HCV cirrhosis and hypersplenism to receive sufficient IFN therapy. Therefore, Lap-Sp can become a strong supportive surgery for cirrhotic patients who require antiviral therapy.
AuthorsTomohiko Akahoshi, Morimasa Tomikawa, Hirofumi Kawanaka, Norihiro Furusyo, Nao Kinjo, Norifumi Tsutsumi, Yoshihiro Nagao, Jun Hayashi, Makoto Hashizume, Yoshihiko Maehara
JournalJournal of gastroenterology and hepatology (J Gastroenterol Hepatol) Vol. 27 Issue 2 Pg. 286-90 (Feb 2012) ISSN: 1440-1746 [Electronic] Australia
PMID21793908 (Publication Type: Journal Article)
Copyright© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Chemical References
  • Antiviral Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2b
Topics
  • Adult
  • Aged
  • Antiviral Agents (adverse effects, therapeutic use)
  • Combined Modality Therapy
  • Drug Therapy, Combination
  • Female
  • Hand-Assisted Laparoscopy
  • Hepatitis C (complications, diagnosis, therapy)
  • Humans
  • Hypersplenism (therapy, virology)
  • Interferon alpha-2
  • Interferon-alpha (adverse effects, therapeutic use)
  • Japan
  • Laparoscopy (adverse effects)
  • Liver Cirrhosis (therapy, virology)
  • Male
  • Middle Aged
  • Polyethylene Glycols (adverse effects, therapeutic use)
  • Recombinant Proteins (adverse effects, therapeutic use)
  • Ribavirin (therapeutic use)
  • Splenectomy (adverse effects, methods)
  • Thrombocytopenia (therapy, virology)
  • Time Factors
  • Treatment Outcome

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