Splenomegaly as risk factor of liver cirrhosis. A retrospective cohort study of 2,525 patients who underwent laparoscopy.

The aim of this study was to evaluate the meaning of laparoscopic splenomegaly and its relationship with the severity and evolution of liver cirrhosis. Medical records of 2,525 consecutive patients with chronic liver diseases who underwent laparoscopy and video-guided hepatic biopsy were reviewed. There were 1,610 (63.8%) men and 915 (36.2%) women. All patients underwent gastroscopy to diagnose esophageal varices. The diagnosis of cirrhosis was made in 910 (36.0%) patients, while 620 (24.6%) had hepatic fibrosis, and 995 (39.4%) chronic active hepatitis. Splenomegaly was present in 460 out of 910 patients (50.5%) with cirrhosis. Among the 1,615 patients without cirrhosis, splenomegaly was present in 80 (4.9%), and esophageal varices were present in 70 out of 910 (7.6%) cirrhotic patients. In patients without cirrhosis, esophageal varices were present in 30 out of 1,615 (1.2%) at the time of laparoscopy. Statistical analysis showed significant differences between patients with cirrhosis and without cirrhosis for splenomegaly (chi(2)=717.03, p<0.001) and esophageal varices (chi(2)=50.57, p<0.001). In conclusion, laparoscopic splenomegaly seems to be an important prognostic factor in liver cirrhosis, which represents a risk factor for portal hypertension.