Portal vein thrombosis after hepatectomy.

Abstract:

BACKGROUND:Although various complications after hepatectomy have been reported, there have been no large studies on postoperative portal vein thrombosis (PVT) as a complication. This study evaluated the incidence, risk factors, and clinical outcomes of PVT after hepatectomy. METHODS:The preoperative and postoperative clinical characteristics of patients who underwent hepatectomy were retrospectively analyzed. RESULTS:A total of 208 patients were reviewed. The incidence of PVT after hepatectomy was 9.1 % (n = 19), including main portal vein (MPV) thrombosis (n = 7) and peripheral portal vein (PPV) thrombosis (n = 12). Patients with MPV thrombosis had a significantly higher incidence of right hepatectomy (p < 0.001), larger resection volume (p = 0.003), and longer operation time (p = 0.021) than patients without PVT (n = 189). Multivariate analysis identified right hepatectomy as a significant independent risk factor for MPV thrombosis (odds ratio 108.9; p < 0.001). Patients with PPV thrombosis had a significantly longer duration of Pringle maneuver than patients without PVT (p = 0.002). Among patients who underwent right hepatectomy, those with PVT (n = 6) had a significantly lower early liver regeneration rate than those without PVT (n = 13; p = 0.040), and those with PVT had deterioration of liver function on postoperative day 7. In all patients with MPV thrombosis who received anticoagulation therapy, PVT subsequently resolved. CONCLUSIONS:Postoperative PVT after hepatectomy is not rare. It is closely related to delayed recovery of liver function and delayed liver regeneration.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Yoshiya S,Shirabe K,Nakagawara H,Soejima Y,Yoshizumi T,Ikegami T,Yamashita Y,Harimoto N,Nishie A,Yamanaka T,Maehara Y

doi

10.1007/s00268-013-2440-8

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

1491-7

issue

6

eissn

0364-2313

issn

1432-2323

journal_volume

38

pub_type

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