{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T23:18:34Z","timestamp":1789514314507,"version":"build-2803163510"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2014,9,9]],"date-time":"2014-09-09T00:00:00Z","timestamp":1410220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["25893166"],"award-info":[{"award-number":["25893166"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,10,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The effect of splenomegaly in patients with liver cirrhosis and portal hypertension is not fully understood. This study was designed to determine the effect of laparoscopic splenectomy on portal haemodynamics in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with liver cirrhosis and portal hypertension who underwent laparoscopic splenectomy in Kyushu University Hospital from January 2006 to March 2009 were evaluated retrospectively. Correlations between splenic size and portal haemodynamics, and changes in portal haemodynamics and in levels of the vasoactive agents endothelin (ET) 1 and nitric oxide metabolites (NOx) before and 7\u201310 days after laparoscopic splenectomy were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Portal venous (PV) blood flow, PV cross-sectional area and PV congestion index correlated significantly with splenic size (P &amp;lt; 0\u00b7050). All three were significantly reduced following splenectomy in 59 patients. The hepatic venous pressure gradient, measured in 18 patients, decreased by 25 per cent after splenectomy (P &amp;lt; 0\u00b7001). Portal vascular resistance was also reduced, by 21 per cent (P = 0\u00b7009). The peripheral blood concentration of ET-1 decreased from 2\u00b795 to 2\u00b711 pg\/ml (P &amp;lt; 0\u00b7001), and that of NOx tended to decrease (from 29\u00b72 to 25\u00b70 pg\/ml; P = 0\u00b7068). In hepatic venous blood, the level of ET-1 decreased from 2\u00b737 to 1\u00b783 pg\/ml (P = 0\u00b7006), whereas NOx concentration tended to increase (from 24\u00b75 to 30\u00b79 pg\/ml; P = 0\u00b7067).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with liver cirrhosis and portal hypertension, splenectomy reduced portal venous pressure. A decrease in splanchnic blood flow, by eliminating splenic blood flow, and reduction in intrahepatic vascular resistance, by normalizing hepatic concentrations of ET-1 and NOx, may both have contributed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.9622","type":"journal-article","created":{"date-parts":[[2014,9,9]],"date-time":"2014-09-09T08:53:37Z","timestamp":1410252817000},"page":"1585-1593","source":"Crossref","is-referenced-by-count":51,"title":["Effect of laparoscopic splenectomy on portal haemodynamics in patients with liver cirrhosis and portal hypertension"],"prefix":"10.1093","volume":"101","author":[{"given":"H","family":"Kawanaka","sequence":"first","affiliation":[{"name":"Department of Surgery and Multidisciplinary Treatment, Kyushu University, Fukuoka, Japan"},{"name":"Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 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