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Gastroenterology Research and Practice
Volume 2014 (2014), Article ID 292689, 8 pages
http://dx.doi.org/10.1155/2014/292689
Review Article

Pharmacologic Prophylaxis of Portal Venous System Thrombosis after Splenectomy: A Meta-Analysis

1Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang 110840, China
2Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, Shaanxi 710032, China

Received 13 June 2014; Accepted 18 July 2014; Published 27 August 2014

Academic Editor: Valerio De Stefano

Copyright © 2014 Xingshun Qi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Portal venous system thrombosis (PVST) is a life-threatening complication of splenectomy. A meta-analysis was conducted to explore the role of pharmacologic prophylaxis of PVST after splenectomy. Overall, 359 papers were initially identified via the PubMed, EMBASE, and Cochrane Library databases. Eight of them were eligible. The incidence of PVST after splenectomy was significantly lower in patients who received the preventive measures than in those who did not (odds ratio [OR]: 0.33, 95% confidence interval [CI]: 0.22–0.47, ). Subgroup analyses demonstrated that the significant difference remained in studies including patients with portal hypertension (), but not in those including patients with hematological diseases (); the significant difference remained in studies using any type of prophylactic drugs (anticoagulants [], thrombolytics [], and prostaglandin E1 []); the significant difference remained in nonrandomized studies (), but not in randomized studies (). The risk of bleeding was similar between the two groups (OR: 0.65, 95% CI: 0.10–4.04, ). In conclusion, pharmacologic prophylaxis might decrease the incidence of PVST after splenectomy in patients with portal hypertension and did not increase the risk of bleeding. However, the effect of pharmacologic prophylaxis of PVST in patients with hematological diseases remained questioned.