Clinical indicators of liver regeneration after splenectomy in patients with cirrhotic Portal Hypertension

Aim Laparoscopic splenectomy and esophagogastric devascularization (LSED) is a minimally invasive and effective approach for managing esophagogastric variceal bleeding (EVB) secondary to portal hypertension (PHT). The increased liver volume (LV) after LSED was observed and proved to be liver regeneration, but the potential benefits and associated clinical factors remain unidentified. In this study, we investigated the association between LV enlargement and some chosen clinical indicators after LSED, aiming to identify positive clinical factors that may indicate liver regeneration after LSED. Methods A total of 102 patients who underwent LSED were retrospectively enrolled. LV and clinical data were documented preoperatively and 6 months postoperatively. Patients’ characteristics, perioperative variables, and follow-up outcomes were collected. Logistic regression was used to identify the factors associated with postoperative increased LV. Kaplan-Meier analysis estimated recurrent hemorrhage-free survival (RHFS). Results LV increased in 67 patients, while 35 patients experienced a decrease of LV postoperatively. Compared with the decreased LV group, the increased LV group showed elevated peripheral blood cells count and alleviated liver function after LSED. We further revealed that the liver/spleen volume ratio and postoperative changes in PLT and WBC counts were positively associated with the increase in LV. Patients with increased PLT counts greater than 150 × 10 ⁹ /L at 6 months after LSED had significantly increased LV and RHFS. Conclusions LSED effectively relieves portal hypertension, leading to improvement in liver function and expansion of LV. Patients with increased LV after LSED showed more significant improvement in liver function.