Risk Factors for Postoperative Complications After Splenectomy in Wilson’s Disease: A 986-Patient Single-Center Cohort Study

INTRODUCTION: Splenectomy is commonly performed in Wilson's disease patients with hypersplenism secondary to portal hypertension, yet large-scale data on postoperative complications remain scarce. METHODS: A retrospective analysis was conducted on 986 Wilson's disease patients who underwent splenectomy between 2001 and 2019. RESULTS: The overall postoperative complication rate was 68.7%, with bleeding, fever, and portal vein thrombosis occurring in 29.0%, 44.9%, and 20.5% of cases, respectively. Multivariable analysis identified hypersplenism grade as an independent risk factor for postoperative bleeding, abnormal liver function for postoperative fever, and lower alanine aminotransferase and albumin levels for portal vein thrombosis. DISCUSSION: These findings suggest that preoperative evaluation of hypersplenism severity, liver function, and key laboratory markers can aid in surgical risk stratification and optimize perioperative management for Wilson's disease patients undergoing splenectomy.