Cirrhosis, Liver, Lipid Profiles, Portal Hypertension, Splenectomy; Status
Conditions
Keywords
Cirrhosis, Splenectomy, Laparoscopy, Lipid Profiles, azygoportal disconnection, hypersplenism, Portal Hypertension Bleeding
Brief summary
Patients with liver cirrhosis frequently exhibit dyslipidemia due to impaired hepatic lipid synthesis, altered bile acid metabolism, and portal hypertension. Laparoscopic Splenectomy and Azygoportal Disconnection (LSD) is commonly used to treat Cirrhosis with Portal Hypertension Bleeding in these patients, but its impact on lipid profiles within 1 year postoperatively remains poorly characterized. This study will follow patients undergoing LSD to measure changes in serum lipid parameters before and after surgery, identify risk factors for lipid profile deterioration or improvement, and determine whether LSD can ameliorate dyslipidemia in the long term, thereby informing metabolic management strategies in cirrhotic patients.
Detailed description
This study is a single-center retrospective medical record analysis. Patients who had undergone laparoscopic splenectomy and azygoportal disconnection were screened and included in medical records. Preoperative baseline data, as well as laboratory and clinical data at 3, 6, 9, and 12 months postoperatively, were extracted from the medical records to analyze the dynamic trends of four serum lipid parameters (total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol). Intraoperative indicators, postoperative complications, albumin, bilirubin, and changes in Child-Pugh liver function classification were also collected as secondary outcome measures for statistical analysis.
Interventions
None listed
Sponsors
Northern Jiangsu People's Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Age 18-80 years, male or female 2. Confirmed diagnosis of liver cirrhosis (clinical, laboratory, imaging) 3. Splenomegaly and hypersplenism 4. History of portal hypertension bleeding (esophageal and gastric variceal bleeding ) 5. Child-Pugh Class A or B liver function 6. Ability to complete 12-month follow-up
Exclusion criteria
1. Child-Pugh Class C liver cirrhosis 2. Previous abdominal surgery precluding safe laparoscopic splenectomy and azygoportal disconnection 3. Severe cardiac, pulmonary, cerebrovascular dysfunction; malignant tumors; primary hematological disorders 4. Metabolic/endocrine diseases: Familial hyperlipidemia; uncontrolled severe diabetes mellitus, thyroid dysfunction, nephrotic syndrome; use of lipid-lowering drugs, hormones, or other drugs affecting blood lipids within 1 month before surgery. 5. Infections/inflammatory diseases: Active hepatitis, severe infections, or autoimmune diseases. 6. Cirrhotic complications (hepatic encephalopathy, refractory ascites) within 1 month before surgery 7. Pregnancy or lactation 8. Poor compliance, inability to complete follow-up
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total triglycerides (TG) level | baseline, postoperative month 3, month 6, month 9, month 12, | Change in total triglycerides (TG) level |
| Total cholesterol (TC) leve | baseline, and postoperative month 3, month 6, month 9,month 12 | Change in total cholesterol (TC) level |
| High-density lipoprotein cholesterol (HDL-C) | baseline, and postoperative month 3, month 6, month 9,month 12, | Change in high-density lipoprotein cholesterol (HDL-C) level |
| Low-density lipoprotein cholesterol (LDL-C) | baseline, and postoperative month 3, month 6, month 9, month 12, | Change in low-density lipoprotein cholesterol (LDL-C) level |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| albumin, bilirubin | baseline, and postoperative month 3, month 6, month 9, month 12, | albumin, bilirubin level |
| Child-Pugh grade | baseline, and postoperative month 3, month 6, month 9,month 12, | Changes in Child-Pugh grade The Child-Pugh score is calculated based on five parameters, each assigned 1, 2, or 3 points. 1. Total bilirubin · Less than 2 mg/dL: 1 point · 2-3 mg/dL: 2 points · Greater than 3 mg/dL: 3 points 2. Serum albumin · Greater than 3.5 g/dL: 1 point · 2.8-3.5 g/dL: 2 points · Less than 2.8 g/dL: 3 points 3. Prothrombin time prolongation or INR · Prolongation less than 4 seconds (INR \< 1.7): 1 point · Prolongation 4-6 seconds (INR 1.7-2.3): 2 points · Prolongation greater than 6 seconds (INR \> 2.3): 3 points 4. Ascites · None: 1 point · Mild or controlled with diuretics: 2 points · Moderate to severe or refractory: 3 points 5. Hepatic encephalopathy · None: 1 point · Grade I-II: 2 points · Grade III-IV: 3 points Total score and corresponding grade · 5-6 points: Child-Pugh class A · 7-9 points: Child-Pugh class B · 10-15 points: Child-Pugh class C |
Countries
China
Contacts
STUDY_CHAIRGuo-Qing Jiang, MD
Clinical Medical College of Yangzhou University
Outcome results
None listed