ObjectiveTo investigate the predictive factors of portal vein thrombosis (PVT) before and after splenectomy and gastroesophageal devascularization for liver cirrhosis with portal hypertension. MethodsSixty-one cases of liver cirrhosis with portal hypertension who underwent splenectomy and gastroesophageal devascularization were enrolled retrospectively. The patients were divided into PVT group and non-PVT group based on the presence or absence of postoperative PVT on day 7. The clinical factors related with PVT were analyzed. ResultsThere were 25 cases in the DVT group and 36 cases in the non-DVT group. The results of univariate analysis showed that the preoperative platelet (P=0.006), activated partial thromboplastin time (P=0.048), prothrombin time (P=0.028), and international normalized ratio (P=0.029), postoperative fibrin degradation product (P=0.002) and D-dimer (P=0.014) on day 1, portal venous diameter (P=0.050) had significant differences between the DVT group and non-DVT group. The results of logistic multivariate regression analysis showed that the preoperative platelet (OR=0.966, 95% CI 0.934-1.000, P=0.048) and postoperative fibrin degradation product on day 1(OR=1.055, 95% CI 1.011-1.103, P=0.017) were correlated with the PVT. The PVT might happen when preoperative platelet was less than 34.5×109/L (sensitibity 80.6%, specificity 60.0%) or postoperative fibrin degradation product on day 1 was more than 64.75 mg/L (sensitibity 48.0%, specificity 91.7%). ConclusionPreoperative platelet and postoperative fibrin degradation product on day 1 might predict PVT after splenectomy and gastroesophageal devascularization for liver cirrhosis with portal hypertension.