Background and study aim: In patients
suffering from portal hypertension as
result of liver cirrhosis, hypersplenism
was ranged from 11 to 55%. The aim of our
work was to compare between percutaneous
microwave ablation (MWA) and partial
splenic artery embolization (PSE) in the
management of hypersplenism in patients
with liver cirrhosis as regard efficacy and
safety.
Patients and Methods: Sixty patients
with liver cirrhosis complicated with
splenomegaly and hypersplenism were
divided randomly into three groups; Group
(1): Twenty patients were underwent one
session of MW ablation of splenic
parenchyma with target ablation volume
about 20%, Group (2): Twenty patients
were underwent two sessions of MW
ablation of splenic parenchyma with 1
week interval with target ablation up to
40%, Group (3): Twenty patients were
underwent PSE.
Results: There was an improvement in
the hemoglobin, platelet and leucocyte
levels in three groups, which was 9.47±
2.14 gm/dl, 42.75 ± 15.4 x103
/ mm3
and
2.6±0.5 x103
/mm3 before the procedure
respectively and become 9.95 ± 2.29
gm/dl, 313.5±99.6 x103
/mm3
and 6.88±
1.89 x103
/mm3
after one month as regard
PSE group. As regard one session of
MWA was 9.73±2.02 gm/dl, 45.57±11.2
x103
/mm3
and 2.8±0.85 x103
/mm3
and
become 11.83±0.74 gm/dl, 152±26.43
x103
/mm3
and 5.85±1.01 x103
/mm3
after
one month. As regard two sessions of
MWA group; was 9.2±2.15 gm/dl, 40.6±
11.5 x103
/mm3
and 2.4±0.55 x103
/mm3
and become 12.74±1.2 gm/dl, 183.4±
26.43 x103
/mm3
and 6.29±1.17 x103
/mm3
after one month. PSE was significantly
more effective in the elevation of platelets
and leucocytes than other two groups
(p=0.00), and two sessions of MWA more
than one session of MWA. The two
sessions MWA group was significantly
higher than other two groups while one
session of MWA group was more than
PSE group in the elevation of hemoglobin
(p=0.00). No mortality occurred in the
three groups, but PSE was associated with
more serious complications than the other
two groups.
Conclusion: MWA and PSE were effective
in treatment of hypersplenism in patients
with liver cirrhosis, while percutaneous
MWA has less serious complications than
PSE |
