Splenic/portal vein thrombosis is an alarming complication of splenectomy. Retrospective
studies in the literature have shown the incidence of symptomatic splenic/portal vein
thrombosis to be between 0.7% (Rattner et al., 1993) to 8% (Winslow et al., 2002). This is a
single-center, prospective, randomized study in subjects undergoing laparoscopic splenectomy.
All participants will receive one dose of pre-operative low molecular weight heparin
(Lovenox®) subcutaneously, 2 hours prior to surgery. Participants will be randomized
pre-operatively to treatment or control group however the treatment allocation will not be
revealed until the surgery is complete. Postoperatively, those assigned to the treatment
group will receive 40 mg of Lovenox® subcutaneously once a day for 21 days; those in the
control group will not. Patients with severe renal impairment will receive an adjusted dose
of Lovenox® (30 mg subcutaneous dose daily). All patients will have a baseline abdominal
Doppler ultrasound preoperatively and a second one done at 14 to 28 days post surgery to
monitor for the presence of portal vein and/or splenic vein thrombosis. They will also have
their lipase and liver function tests checked to correlate with the imaging findings.