Percutaneous Microwave Ablation versus Partial Splenic Embolization for Treatment of Hypersplenism in Patients with Liver Cirrhosis | ||||
| Afro-Egyptian Journal of Infectious and Endemic Diseases | ||||
| Article 6, Volume 9, Issue 3, September 2019, Page 230-240 PDF (434.04 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/aeji.2019.14763.1030 | ||||
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| Authors | ||||
Yousef Mohammed Asar  1; Mostafa Soliman El Kady1; Hatem Samir Alegaily 1; Waleed Ahmed El Agawy2; Tamer El Eraki1; Wessam Mostafa Abd El Latif3
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| 1Hepatology, Gastroentrology and Infectious Diseases Department, Faculty Of Medicine, Benha University. Benha, Egypt | ||||
| 2Tropical Medicine Department, Faculty of Medicine, Port Said University, Port Said, Egypt | ||||
| 3Fellow of Diagnostic and Interventional Radiology ,National Hepatology and Tropical Medicine Institute, Cairo, Egypt | ||||
| Abstract | ||||
| 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. | ||||
| Keywords | ||||
| Liver cirrhosis; Hypersplenism; Percutaneous Microwave Ablation; Partial Splenic Embolization | ||||
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