To summarize the distribution and incidence of early portal venous system thrombosis (PVST) after splenectomy combined with pericardial devascularization.

The clinical data of 96 cases of portal hypertension who received splenectomy combined with pericardial devalcularization in Ningxia Hui Autonomous Region Hospital was retrospectively analyzed. Early postoperately, heparine saline was infused through the catheter placed in the right gastroepiploic vein during operation. The PVST occurrence was observed within 2 weeks after operation.

PVST occurred in all of the 96 cases (100.0%). Distribution of the PVST was as follows: remnant splenic vein in 96 cases (100.0%), porto-mensenteric vein in 38 cases (39.6%) including main portal vein in 32 cases (33.3%). In main portal vein thrombosis, the rate of thrombus/portal vein cross-sectional area was <50% in 14 cases (14.6%), 50% in 14 cases (14.6%) and complete thrombus in 4 cases (4.2%). All of the thrombus in themain portal vein was connected with those in remnant splenic vein. Thrombosis was found in superior mesenteric vein (SMV) in 6 cases (6.3%), in which, SMV thombosis was associated and connected with main portal vein thrombosis in 4 cases and SMV thrombosis was associated with portal vein branch thrombosis and connected with the remnant splenic vein thrombosis in 2 cases. Right portal vein thrombosis occurred in 18 cases (18.8%) and left portal vein thrombosis in 20 (20.8%). Thrombosis occurrence≥2 sites of the portomensenteric vein was in 24 cases (25.0%).

The remnant splenic vein tends to form thrombosis in the early time after splenectomy combined with pericardial devacularization for portal hypertension with liver cirrosis. Extension of the remnant splenic vein thrombosis would be the key factor of portomensenteric vein thrombosis.