Successful Treatment of Hypersplenism in Wilson's Disease by Partial Splenic Embolization.

AIM: Hypersplenism can occur in patients with Wilson's disease (WD). Surgical splenectomy is a conventional treatment for this condition; however, emotional and neurological deterioration may follow splenectomy. In recent years, partial splenic embolization (PSE) has been increasingly performed as a nonsurgical alternative treatment for hypersplenism. The aim of this study was to evaluate the effectiveness and safety of PSE compared with splenectomy in the treatment of hypersplenism in WD patients. METHODS: Fifty WD patients with hypersplenism were randomly divided into two groups (group A and group B), each including 25 patients. Patients in groups A and B were treated with PSE and splenectomy, respectively. Data were collected on the clinical efficacy of each procedure, adverse reactions, hematologic and blood chemistry test results, and abdominal computed tomography (CT) scan findings (group A only). RESULTS: Marked improvements in the platelet and leukocyte counts after PSE and splenectomy were observed in all patients. PSE was associated with improved liver function without severe complications, and no significant changes in emotional and neurological symptoms were observed. In contrast, seven WD patients suffered neurological deterioration after splenectomy. CONCLUSIONS: Hypersplenism in WD patients was successfully treated by PSE, which appears to be a safe and effective alternative treatment for WD-induced hypersplenism.

[Study on primary hepatocellular carcinoma associated with hypersplenism treated by partial splenic embolization combined with hepatic arterial chemoembolization].

BACKGROUND & OBJECTIVE: 70-90% of patients of primary hepatocellular carcinoma (PHC) are associated with liver cirrhosis, portal hypertension and hypersplenism. The treatment of PHC is usually hampered by low or slow recovery of blood cell counts. This study was to investigate the effect of partial splenic embolization (PSE) combined with transcatheter hepatic arterial chemoembolization (TACE) for the treatment of PHC with portal hypertension and hypersplenism. METHODS: Efficacy of 26 patients with PSE combined with TACE and 26 patients with single TACE was observed. RESULTS: Satisfactory effects were achieved in PSE combined with TACE group in terms of correction of blood cell counts compared with cases treated with TACE alone. CONCLUSION: PSE associated with TACE is safe and effective for the treatment of patients with PHC associated with liver cirrhosis, portal hypertension and hypersplenism.