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Effect of LSD on Lipid Profiles in Cirrhosis Patients With Portal Hypertension Bleeding (2-Year Follow-Up) (LSD-LPPH)

10. maj 2026 opdateret af: Guo-Qing Jiang, Northern Jiangsu People's Hospital

A Prospective, Single-Center, Observational Cohort Study to Evaluate the Long-Term (2-Year) Effects of Laparoscopic Splenectomy and Azygoportal Disconnection on Lipid Profiles in Patients With Liver Cirrhosis, Portal Hypertension Bleeding.

Patients with liver cirrhosis frequently exhibit dyslipidemia due to impaired hepatic lipid synthesis, altered bile acid metabolism, and portal hypertension. Laparoscopic Splenectomy and Azygoportal Disconnection (LSD) is commonly used to treat Cirrhosis with Portal Hypertension Bleeding in these patients, but its impact on lipid profiles over 2 years remains poorly characterized. This study will follow patients undergoing LSD to measure changes in serum lipid parameters before and after surgery, identify risk factors for lipid profile deterioration or improvement, and determine whether LSD can ameliorate dyslipidemia in the long term, thereby informing metabolic management strategies in cirrhotic patients.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Detaljeret beskrivelse

Rationale: Liver cirrhosis disrupts hepatic lipid homeostasis through multiple mechanisms, including decreased apolipoprotein synthesis, impaired cholesterol esterification, and altered very-low-density lipoprotein (VLDL) secretion, resulting in characteristic lipid abnormalities such as hypocholesterolemia and low high-density lipoprotein cholesterol (HDL-C). Laparoscopic splenectomy combined with azygoportal disconnection (LSD) is commonly used to treat portal hypertension bleeding in these patients, but its impact on lipid profiles over 2 years remains poorly characterized. This study will follow patients undergoing LSD to measure changes in serum lipid parameters before and after surgery, identify risk factors for lipid profile deterioration or improvement, and determine whether LSD can ameliorate dyslipidemia in the long term, thereby informing metabolic management strategies in Cirrhosis with Portal Hypertension Bleeding in these patients.Study Design: Prospective, single-center, observational cohort study with a total duration of 24 months (2 years). Patients with Cirrhosis with Portal Hypertension Bleeding scheduled for elective LSD will be enrolled and followed for 2 years to assess lipid profile dynamics and identify risk factors for metabolic deterioration or improvement. Study Timeline:Months 1-6: Patient screening, enrollment, baseline lipid assessment Months 1-18: Laparoscopic Splenectomy and Azygoportal Disconnection and perioperative short-term lipid monitoring Months 7-24: Long-term follow-up at 3, 6, 9,12, 24 months postoperativelyMonth 24: Data analysis and study completion.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

30

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

  • Kina
    • Jiangsu
      • Yangzhou, Jiangsu, Kina, 225001
        • Clinical Medical College of Yangzhou University
        • Kontakt:
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

Prospective, single-center, observational cohort study with a total duration of 24 months (2 years). Patients with cirrhosis, Splenomegaly and hypersplenism, Portal Hypertension Bleeding scheduled for Laparoscopic Splenectomy and Azygoportal Disconnection (LSD) will be enrolled and followed for 2 years to evaluate dynamic changes in lipid profiles.

Beskrivelse

Inclusion Criteria:

  1. Age 18-80 years, male or female
  2. Confirmed diagnosis of liver cirrhosis (clinical, laboratory, imaging)
  3. Splenomegaly and hypersplenism
  4. History of portal hypertension bleeding (esophageal and gastric variceal bleeding )
  5. Child-Pugh Class A or B liver function
  6. Signed written informed consent
  7. Ability to complete 24-month follow-up

Exclusion Criteria:

  1. Child-Pugh Class C liver cirrhosis
  2. Previous abdominal surgery precluding safe laparoscopic splenectomy and azygoportal disconnection
  3. Severe cardiac, pulmonary, cerebrovascular dysfunction; malignant tumors; primary hematological disorders
  4. Metabolic/endocrine diseases: Familial hyperlipidemia; uncontrolled severe diabetes mellitus, thyroid dysfunction, nephrotic syndrome; use of lipid-lowering drugs, hormones, or other drugs affecting blood lipids within 1 month before surgery.
  5. Infections/inflammatory diseases: Active hepatitis, severe infections, or autoimmune diseases.
  6. Cirrhotic complications (hepatic encephalopathy, refractory ascites) within 1 month before surgery
  7. Pregnancy or lactation
  8. Poor compliance, inability to complete follow-up

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Total cholesterol (TC) level
Tidsramme: at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24
Change in total cholesterol (TC) level
at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24
Total triglycerides (TG) level
Tidsramme: at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24
Change in total triglycerides (TG) level
at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24
High-density lipoprotein cholesterol (HDL-C)
Tidsramme: at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24
Change in high-density lipoprotein cholesterol (HDL-C) level
at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24
Low-density lipoprotein cholesterol (LDL-C)
Tidsramme: at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24
Change in low-density lipoprotein cholesterol (LDL-C) level
at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Child-Pugh grade
Tidsramme: at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24

Changes in Child-Pugh grade The Child-Pugh score is calculated based on five parameters, each assigned 1, 2, or 3 points.

  1. Total bilirubin

    • Less than 2 mg/dL: 1 point
    • 2-3 mg/dL: 2 points
    • Greater than 3 mg/dL: 3 points

  2. Serum albumin

    • Greater than 3.5 g/dL: 1 point
    • 2.8-3.5 g/dL: 2 points
    • Less than 2.8 g/dL: 3 points

  3. Prothrombin time prolongation or INR

    • Prolongation less than 4 seconds (INR < 1.7): 1 point
    • Prolongation 4-6 seconds (INR 1.7-2.3): 2 points
    • Prolongation greater than 6 seconds (INR > 2.3): 3 points

  4. Ascites

    • None: 1 point
    • Mild or controlled with diuretics: 2 points
    • Moderate to severe or refractory: 3 points

  5. Hepatic encephalopathy

    • None: 1 point
    • Grade I-II: 2 points
    • Grade III-IV: 3 points

Total score and corresponding grade

  • 5-6 points: Child-Pugh class A
  • 7-9 points: Child-Pugh class B
  • 10-15 points: Child-Pugh class C
at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24
Intraoperative variables
Tidsramme: During the procedure of operation
operation time, intraoperative blood loss, fluid infusion, mean arterial pressure,
During the procedure of operation
Postoperative complications
Tidsramme: at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24
bleeding, infection, hepatic encephalopathy, ascites
at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24
Albumin, bilirubin
Tidsramme: at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24
Changes in Child-Pugh grade, albumin, bilirubin
at preoperative baseline, postoperative month 1, month 3, month 6, month 12, month 18, month 24

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Northern Jiangsu People's Hospital

Efterforskere

  • Studiestol: Guo-Qing Jiang, MD, Clinical Medical College of Yangzhou University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. maj 2026

Primær færdiggørelse (Anslået)

28. februar 2029

Studieafslutning (Anslået)

28. februar 2029

Datoer for studieregistrering

Først indsendt

1. maj 2026

Først indsendt, der opfyldte QC-kriterier

10. maj 2026

Først opslået (Faktiske)

14. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

14. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

10. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • YZUC-021

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