{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T02:25:34Z","timestamp":1783131934565,"version":"3.54.6"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81573987 and 30973855"],"award-info":[{"award-number":["81573987 and 30973855"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Splenectomy is one crucial solution for hypersplenism with portal hypertension. However, portal vein system thrombosis (PVST) caused by hemodynamic changes affects the prognosis of patients. We analyze the changes in portal vein hemodynamics following splenectomy for Wilson\u2019s disease combined with portal hypertension and the influencing factors that lead to PVST.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was conducted, in which 237 Wilson\u2019s disease patients with hypersplenism underwent splenectomy. The hemodynamic indices of the portal vein were monitored before surgery and on the 1st, 7th, and 14th days around surgery. The patients were divided into PVST and non-PVST groups. The clinical factors were identified by univariate and multivariate logistic regression. The Logit <jats:italic>P<\/jats:italic> was calculated according to the logistic regression prediction model, and the ROC curve for each independent factor was plotted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The portal vein velocity, flow, and inner diameter showed a downward trend around surgery, with statistically significant differences between each time point (<jats:italic>P\u2009<\/jats:italic>&amp;lt;\u20090.01). The PVST incidence rate was 55.7%. Univariate analysis revealed that the platelet (PLT) levels on the postoperative 3rd and 7th days (<jats:italic>P\u2009<\/jats:italic>=\u20090.001; <jats:italic>P\u2009<\/jats:italic>&amp;lt;\u20090.001), D-dimer (D-D) on the postoperative 7th and 14th days (<jats:italic>P\u2009<\/jats:italic>=\u20090.002; <jats:italic>P\u2009<\/jats:italic>&amp;lt;\u20090.001), preoperative portal vein velocity, flow, diameter (<jats:italic>P\u2009<\/jats:italic>&amp;lt;\u20090.001), and splenic vein diameter (<jats:italic>P\u2009<\/jats:italic>&amp;lt;\u20090.001) were all statistically and significantly different between the two groups. Multivariate logistic regression revealed a significant increase in PLT on the postoperative 7th day (OR<jats:italic>\u2009<\/jats:italic>=\u20091.043, 95% CI, 1.027\u20131.060, <jats:italic>P\u2009<\/jats:italic>&amp;lt;\u20090.001) and D-D on the postoperative 14th day (OR\u2009=\u20091.846, 95% CI, 1.400\u20132.435, <jats:italic>P\u2009<\/jats:italic>&amp;lt;\u20090.001). Preoperative portal and splenic vein diameters (OR\u2009=\u20091.565, 95% CI, 1.213\u20132.019, <jats:italic>P\u2009<\/jats:italic>=\u20090.001; OR\u2009=\u20091.671, 95% CI, 1.305\u20132.140, <jats:italic>P\u2009<\/jats:italic>&amp;lt;\u20090.001) were the risk factors for PVST. However, preoperative portal vein velocity and flow (OR\u2009=\u20090.578, 95% CI, 0.409\u20130.818, <jats:italic>P\u2009<\/jats:italic>=\u20090.002; OR<jats:italic>\u2009<\/jats:italic>=\u20090.987, 95% CI, 0.975\u20130.990, <jats:italic>P\u2009<\/jats:italic>=\u20090.046) were protective factors for PVST. Logit <jats:italic>P<\/jats:italic> was calculated using a logistic regression prediction model with a cut-off value of \u22120.32 and an area under receiver operating characteristic curve of 0.952 with 88.61% accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Splenectomy relieves portal hypertension by reducing the hemodynamics index. PVST is linked to multiple factors, including preoperative portal vein diameter, velocity, flow, and splenic vein diameter, especially PLT on the postoperative 7th day and D-D on the postoperative 14th day. The predictive model is accurate in predicting PVST.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.834466","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T06:18:10Z","timestamp":1653891490000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Research on Portal Venous Hemodynamics and Influencing Factors of Portal Vein System Thrombosis for Wilson\u2019s Disease after Splenectomy"],"prefix":"10.3389","volume":"9","author":[{"given":"Zhou","family":"Zheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingsheng","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanzong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuhai","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1023\/b:mebr.0000043973.10494.85","article-title":"Pathophysiology and clinical features of Wilson disease","volume":"19","author":"Ferenci","year":"2004","journal-title":"Metab Brain Dis"},{"key":"B2","doi-asserted-by":"publisher","first-page":"465","DOI":"10.2174\/1570159X18666200429233517","article-title":"Management perspective of Wilson\u2019s disease: early diagnosis and individualized therapy","volume":"19","author":"Yuan","year":"2021","journal-title":"Curr Neuropharmacol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1177\/000313482008600429","article-title":"Significance of amylase monitoring in peritoneal drainage fluid after splenectomy: a clinical analysis of splenectomy in 167 patients with hepatolenticular degeneration","volume":"86","author":"Shen","year":"2020","journal-title":"Am Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1159\/000321648","article-title":"Neurology in the people\u2019s republic of china\u2013an update","volume":"64","author":"Wang","year":"2010","journal-title":"Eur Neurol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"394","DOI":"10.4103\/1119-3077.201431","article-title":"Portal venous thrombosis developing after torsion of a wandering spleen","volume":"20","author":"Yilmaz","year":"2017","journal-title":"Niger J Clin Pract"},{"key":"B6","first-page":"2098","article-title":"Thrombolytic treatment of portal thrombosis","volume":"50","author":"Malkowski","year":"2003","journal-title":"Hepatogastroenterology"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2564","DOI":"10.1016\/j.cgh.2020.02.037","article-title":"Prevalence and clinical significance of portal vein thrombosis in patients with cirrhosis and acute decompensation","volume":"18","author":"Zhang","year":"2020","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1080\/00325481.2017.1343646","article-title":"Combined Rex-bypass shunt with pericardial devascularization alleviated prehepatic portal hypertension caused by cavernomatous transformation of portal vein","volume":"129","author":"Wang","year":"2017","journal-title":"Postgrad Med"},{"key":"B9","first-page":"15260","article-title":"Short-term effects of splenectomy on serum fibrosis indexes in liver cirrhosis patients","volume":"8","author":"Kong","year":"2015","journal-title":"Int J Clin Exp Pathol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1097\/SLE.0000000000000710","article-title":"Risk factors and anticoagulation effects of portal vein system thrombosis after laparoscopic splenectomy in patients with or without cirrhosis","volume":"29","author":"Huang","year":"2019","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"B11","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1016\/j.jhep.2011.11.007","article-title":"EASL clinical practice guidelines: Wilson\u2019s disease","volume":"56","year":"2012","journal-title":"J Hepatol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1002\/cld.679","article-title":"Evaluation and management of acute and chronic portal vein thrombosis in patients with cirrhosis","volume":"10","author":"Young","year":"2018","journal-title":"Clin Liver Dis (Hoboken)"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e0194557","DOI":"10.1371\/journal.pone.0194557","article-title":"Validation of automated lobe segmentation on paired inspiratory-expiratory chest CT in 8-14 year-old children with cystic fibrosis","volume":"13","author":"Konietzke","year":"2018","journal-title":"PLoS One"},{"key":"B14","doi-asserted-by":"publisher","first-page":"425","DOI":"10.3233\/WOR-182694","article-title":"More than a job: career development of individuals with cystic fibrosis","volume":"59","author":"Saldana","year":"2018","journal-title":"Work"},{"key":"B15","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.prostaglandins.2015.05.008","article-title":"Arachidonic acid metabolites and endothelial dysfunction of portal hypertension","volume":"120","author":"Sacerdoti","year":"2015","journal-title":"Prostaglandins Other Lipid Mediat"},{"key":"B16","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1016\/j.jamcollsurg.2015.04.011","article-title":"Laparoscopic splenectomy with technical standardization and selection criteria for standard or hand-assisted approach in 390 patients with liver cirrhosis and portal hypertension","volume":"221","author":"Kawanaka","year":"2015","journal-title":"J Am Coll Surg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"160","DOI":"10.4329\/wjr.v6.i5.160","article-title":"Partial splenic artery embolization in cirrhotic patients","volume":"6","author":"Hadduck","year":"2014","journal-title":"World J Radiol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1111\/j.1432-2277.2010.01062.x","article-title":"Evolving experience with prevention and treatment of splenic artery syndrome after orthotopic liver transplantation","volume":"23","author":"Mogl","year":"2010","journal-title":"Transpl Int"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e0124569","DOI":"10.1371\/ journal.pone.0124569","article-title":"Successful splenectomy for hypersplenism in Wilson\u2019s disease: a single center experience from China","volume":"10","author":"Li","year":"2015","journal-title":"PLoS One"},{"key":"B20","first-page":"S25","article-title":"Interplay of portal pressure, portal perfusion and hepatic arterial inflow in modulating expression of hepatic encephalopathy in patients with spontaneous or artificially created portosystemic shunts","volume":"22","author":"Mullen","year":"2003","journal-title":"Indian J Gastroenterol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"72","DOI":"10.3760\/cma.j.cn501113-20190716-00248","article-title":"Study of portal venous pressure gradient to predict high-hepatic encephalopathy-risk population post TIPS","volume":"29","author":"Zhang","year":"2021","journal-title":"Zhonghua Gan Zang Bing Za Zhi"},{"key":"B22","doi-asserted-by":"publisher","first-page":"4371","DOI":"10.1007\/s00464-013-3057-6","article-title":"Laparoscopic splenectomy plus preoperative endoscopic variceal ligation versus splenectomy with pericardial devascularization (Hassab\u2019s operation) for control of severe varices due to portal hypertension","volume":"27","author":"Zhou","year":"2013","journal-title":"Surg Endosc"},{"key":"B23","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1089\/lap.2016.0511","article-title":"Effective prevention for portal venous system thrombosis after splenectomy: a meta-analysis","volume":"27","author":"Zhang","year":"2017","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"B24","doi-asserted-by":"publisher","first-page":"2119","DOI":"10.1007\/s00464-015-4476-3","article-title":"Screening for thrombophilia does not identify patients at risk of portal or splenic vein thrombosis following laparoscopic splenectomy","volume":"30","author":"Manouchehri","year":"2016","journal-title":"Surg Endosc"},{"key":"B25","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1089\/lap.2015.0481","article-title":"Risk factors for portal vein system thrombosis after laparoscopic splenectomy in cirrhotic patients with hypersplenism","volume":"26","author":"Jiang","year":"2016","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"B26","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.ijsu.2015.02.005","article-title":"Effects of surgical procedures on the occurrence and development of postoperative portal vein thrombosis in patients with cirrhosis complicated by portal hypertension","volume":"16","author":"Sun","year":"2015","journal-title":"Int J Surg"},{"key":"B27","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1016\/s1499-3872(13)60081-8","article-title":"Risk factors and clinical characteristics of portal vein thrombosis after splenectomy in patients with liver cirrhosis","volume":"12","author":"Li","year":"2013","journal-title":"Hepatobiliary Pancreat Dis Int"},{"key":"B28","doi-asserted-by":"publisher","first-page":"513","DOI":"10.3760\/cma.j.issn.1007-3418.2016.07.006","article-title":"Clinical features of liver cirrhosis complicated by portal vein thrombosis and related risk factors","volume":"24","author":"Lin","year":"2016","journal-title":"Zhonghua Gan Zang Bing Za Zhi"},{"key":"B29","doi-asserted-by":"publisher","first-page":"423","DOI":"10.5152\/tjg.2015.0063","article-title":"The incidence and risk factors of portal vein system thrombosis after splenectomy and pericardial devascularization","volume":"26","author":"Wu","year":"2015","journal-title":"Turk J Gastroenterol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1007\/s00595-018-1655-6","article-title":"Predictors of portal and splenic vein thrombosis after laparoscopic splenectomy: a retrospective analysis of a single-center experience","volume":"48","author":"Kuroki","year":"2018","journal-title":"Surg Today"},{"key":"B31","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1097\/MEG.0000000000000325","article-title":"De-novo portal vein thrombosis in liver cirrhosis: risk factors and correlation with the model for end-stage liver disease scoring system","volume":"27","author":"Abdel-Razik","year":"2015","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"165","DOI":"10.4103\/1319-3767.157567","article-title":"Role of D-dimer in the development of portal vein thrombosis in liver cirrhosis: a meta-analysis","volume":"21","author":"Dai","year":"2015","journal-title":"Saudi J Gastroenterol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"6588","DOI":"10.3748\/wjg.v13.i48.6588","article-title":"Predictive value of D-dimer for portal vein thrombosis after portal hypertension surgery in hepatitis B virus-related cirrhosis","volume":"13","author":"Deng","year":"2007","journal-title":"World J Gastroenterol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1007\/5584_2016_119","article-title":"Portal vein thrombosis after splenic and pancreatic surgery","volume":"906","author":"Ruiz-Tovar","year":"2017","journal-title":"Adv Exp Med Biol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"76S","DOI":"10.1177\/1076029618788180","article-title":"P-selectin level at first and third day after portal hypertensive splenectomy for early prediction of portal vein thrombosis in patients with cirrhosis","volume":"24","author":"Wei","year":"2018","journal-title":"Clin Appl Thromb Hemost"},{"key":"B36","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1111\/j.1538-7836.2009.03584.x","article-title":"Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis","volume":"8","author":"Chu","year":"2010","journal-title":"J Thromb Haemost"},{"key":"B37","doi-asserted-by":"publisher","first-page":"2096","DOI":"10.1182\/blood-2003-08-2804","article-title":"Characterization of the proteins released from activated platelets leads to localization of novel platelet proteins in human atherosclerotic lesions","volume":"103","author":"Coppinger","year":"2004","journal-title":"Blood"},{"key":"B38","doi-asserted-by":"publisher","first-page":"49","DOI":"10.11613\/BM.2012.006","article-title":"Inflammation and haemostasis","volume":"22","author":"Margetic","year":"2012","journal-title":"Biochem Med (Zagreb)"},{"key":"B39","doi-asserted-by":"publisher","first-page":"401","DOI":"10.3109\/09537104.2012.710858","article-title":"Stroke or coronary artery disease prediction from mean platelet volume in patients with type 2 diabetes mellitus","volume":"24","author":"Han","year":"2013","journal-title":"Platelets"},{"key":"B40","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1089\/lap.2015.0481","article-title":"Risk factors for portal vein system thrombosis after laparoscopic splenectomy in cirrhotic patients with hypersplenism","volume":"26","author":"Jiang","year":"2016","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"B41","first-page":"405","article-title":"Era of liver transplantation: combined anatomic splenectomy and anticoagulant therapy in prevention of portal vein thrombosis after splenectomy","volume":"62","author":"Hongwei","year":"2015","journal-title":"Hepatogastroenterology"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.834466\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T06:18:17Z","timestamp":1653891497000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.834466\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,30]]},"references-count":41,"alternative-id":["10.3389\/fsurg.2022.834466"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2022.834466","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,30]]},"article-number":"834466"}}