Abstract: Objective To analyze the incidence and clinical characteristics of spontaneous splenorenal shunts (SSRS) in patients with hepatitis B-related liver cirrhosis, aiming to provide insight into improving patients′ prognosis. Methods A retrospective study was conducted on 126 patients with hepatitis B-relate cirrhosis who were admitted and treated between February 2021 and February 2025. The patients were divided into a shunt group (n=40) and a non-shunt group (n=86) based on the presence or absence of SSRS. The clinical data of the patients in both groups were collected. SSRS were classified based on ultrasonographic features, and clinical data were compared across different shunt types. Multivariate logistic regression analysis was used to identify factors associated with the occurrence of SSRS. Results Among the 126 patients, 40 (31.7%) developed SSRS. Compared to the non-shunt group, patients in the shunt group had significantly higher levels of serum total bilirubin[(40.2±5.3) μmol/L vs. (34.6±4.5)μmol/L], larger portal vein diameter [(15.8±3.2) mm vs. (13.2±2.1) mm], larger splenic vein diameter (14.7±3.3 mm vs. 12.5±1.4 mm), and higher incidences of hepatic encephalopathy (45.0% vs. 19.8%) and ascites (52.5% vs. 16.3%), with all differences being statistically significant (P<0.05). Serum albumin levels were significantly lower in the shunt group[(26.2±5.6)g/L]compared to the non-shunt group [(35.3±5.2)g/L, P<0.05]. Ultrasound imaging revealed prominent collateral circulation between the splenic vein and the left renal vein in the form of tubular or serpentine vessels, including: direct type, splenic vein directly draining into the left renal vein (25 cases); indirect type, splenic vein draining into the left renal vein via multiple collateral branches (11 cases); complex type, associated with gastrorenal shunt or esophagogastric varices forming a complex network (4 cases). Significant differences in portal vein diameter, splenic vein diameter, incidence of hepatic encephalopathy, and ascites were observed among the different shunt types (P<0.05). Multivariate logistic regression analysis identified serum total bilirubin, serum albumin level, portal vein diameter, splenic vein diameter, hepatic encephalopathy, and ascites as independent risk factors for the development of SSRS in hepatitis B-related cirrhosis patients (OR=3.442, 3.677, 3.540, 3.710, 3.582, 3.732; P<0.05). Conclusion The incidence of SSRS is relatively high in patients with hepatitis B cirrhosis. Serum total bilirubin, albumin levels, portal and splenic vein diameters, hepatic encephalopathy, and ascites are significant influencing factors. These clinical characteristics may help predict the risk of SSRS and improve patients’ prognosis.

Key words: Hepatitis B cirrhosis, Spontaneous splenorenal shunt, Occurrence, Clinical characteristics