Favorable Short-term Outcome after Partial Splenic Embolization (PSE) in Patients with Cirrhotic Liver Disease and Severe Hyperspenism

Backgroud/aims: PSE is an interventional radiological alternative to surgical splenectomy (SN) used for management of hyperplenism in cirrhotic patients and lacks the disadvantages of SN. Despite a significant prevalence of cirrhotic liver disease in Nile Delta, Egypt, sparse PSE-related local data motivated us to investigate the safety and efficacy of PSE in Egyptian cirrhotics with hypersplenism. Patients and methods: A total of eligible 19 cirrhotic patients with severe hypersplenism were enrolled after giving well-informed consent. Patients were subjected to thorough history taking, clinical examination, laboratory, radiological evaluation and upper gastrointestinal endoscopy. Complete blood picture (CBC), serum cholinesterase level, liver biochemistry tests, serum creatinine, prothrombin time, blood and/or ascitic fluid cultures were done once before the procedure, and twice at 2 weeks, 6 months interval post-PSE Results: the embolization technique was done successfully to all patients with a splenic ablation rate of 50-70%, confirmed at 2 wks' post procedure CT with no further repeated sessions on follow-up. PSE significantly improved platelet counts and the other studied hematological parameters. Minor complications occurred in the PSE group while major ones were significant in another age- sex-, Child class-matched SN group. No reported deaths in both groups. Conclusions: our results revealed that PSE could safely and effectively treat cirrhotic patients with hypersplenism. Controlled splenic parenchymal ablation significantly lowers post-PSE morbidity and avoids the disadvantages of SN.