Objective:

To examine the correlation between the spleen volume-to-platelet count ratio (SVPR) and portal pressure, and its association with blood loss during laparoscopic hepatectomy, with a specific focus on differences between anatomical and non-anatomical procedures.

Approach:

• Study Design: A retrospective study utilizing data from patients who underwent laparoscopic hepatectomy for liver tumors, analyzing the correlation between portal pressure and SVPR.
• Data Collection: Data was collected from two datasets: one for portal vein pressure measurements and another for laparoscopic hepatectomy cases from 2019 to 2023.
• Statistical Analysis: ROC analysis was performed to determine the optimal SVPR cutoff for clinically significant portal hypertension, with internal validation using bootstrap resampling.

Key Findings:

• The SVPR correlates with portal pressure.
• Higher SVPR is associated with increased intraoperative blood loss during laparoscopic non-anatomical hepatectomy.
• The study established an optimal SVPR cutoff for predicting clinically significant portal hypertension.

Interpretation:

The findings may provide insights into the relationship between SVPR and portal pressure and intraoperative bleeding risk during laparoscopic liver surgery.

Limitations:

• The study is retrospective and may be subject to biases inherent in such designs.
• Data was collected from a single institution, which may limit generalizability.

Conclusion:

The study suggests that the spleen volume-to-platelet count ratio could be a preoperative marker for assessing bleeding risk in laparoscopic hepatectomy.