Risk Factors and Management of Portal Vein Thrombosis after Hepatectomy: A Single-Center Experience
Objective:. This study investigated the risk factors and management of portal vein thrombosis (PVT) after hepatectomy. Background:. PVT after hepatectomy can cause liver dysfunction and portal hypertension, and may be fatal. However, it has not been sufficiently investigated. Methods:. The study inc...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-12-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000523 |
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| author | Kazuki Wakizaka, MD, PhD Shunsuke Shichi, MD Takeshi Aiyama, MD, PhD Yoh Asahi, MD, PhD Akihisa Nagatsu, MD, PhD Tatsuya Orimo, MD, PhD Tatsuhiko Kakisaka, MD, PhD Akinobu Taketomi, MD, PhD |
| author_facet | Kazuki Wakizaka, MD, PhD Shunsuke Shichi, MD Takeshi Aiyama, MD, PhD Yoh Asahi, MD, PhD Akihisa Nagatsu, MD, PhD Tatsuya Orimo, MD, PhD Tatsuhiko Kakisaka, MD, PhD Akinobu Taketomi, MD, PhD |
| author_sort | Kazuki Wakizaka, MD, PhD |
| collection | DOAJ |
| description | Objective:. This study investigated the risk factors and management of portal vein thrombosis (PVT) after hepatectomy.
Background:. PVT after hepatectomy can cause liver dysfunction and portal hypertension, and may be fatal. However, it has not been sufficiently investigated.
Methods:. The study included 1403 consecutive patients who underwent elective hepatectomy at our department from January 2010 to July 2022. The patients were divided into PVT and non-PVT groups based on the presence or absence of PVT, and relevant risk factors were analyzed. The management and prognosis of patients with PVT were investigated.
Results:. Among the 1403 patients, PVT occurred in 33 cases, giving a frequency of 2.4%. In univariate analyses, female sex (P = 0.03), portal vein reconstruction (P = 0.01), and left lateral sectionectomy (P < 0.001) were significant risk factors for PVT. On multivariate analysis, portal vein reconstruction (P = 0.01) and left lateral segmentectomy (P < 0.001) remained significant risk factors for PVT. The management options for PVT were thrombectomy, antithrombotic therapy, and observation. With antithrombotic therapy, 96.4% of patients achieved PVT resolution. Among patients who underwent hepatectomy with portal vein reconstruction, the PVT site was the main trunk of the portal vein in all 3 cases, and thrombectomy was performed in 2 cases. No perioperative mortality was observed.
Conclusions:. In the present study, portal vein reconstruction and left lateral sectionectomy were identified as risk factors for PVT after hepatectomy. As PVT can be fatal, early detection and appropriate treatment according to the status of PVT are important. |
| format | Article |
| id | doaj-art-a33c6fa67d6c4d02b70a8fd9e0d7b687 |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-a33c6fa67d6c4d02b70a8fd9e0d7b6872025-01-24T09:18:58ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-12-0154e52310.1097/AS9.0000000000000523202412000-00020Risk Factors and Management of Portal Vein Thrombosis after Hepatectomy: A Single-Center ExperienceKazuki Wakizaka, MD, PhD0Shunsuke Shichi, MD1Takeshi Aiyama, MD, PhD2Yoh Asahi, MD, PhD3Akihisa Nagatsu, MD, PhD4Tatsuya Orimo, MD, PhD5Tatsuhiko Kakisaka, MD, PhD6Akinobu Taketomi, MD, PhD7From the * Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, JapanFrom the * Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, JapanFrom the * Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, JapanFrom the * Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, JapanFrom the * Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, JapanFrom the * Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, JapanFrom the * Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, JapanFrom the * Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, JapanObjective:. This study investigated the risk factors and management of portal vein thrombosis (PVT) after hepatectomy. Background:. PVT after hepatectomy can cause liver dysfunction and portal hypertension, and may be fatal. However, it has not been sufficiently investigated. Methods:. The study included 1403 consecutive patients who underwent elective hepatectomy at our department from January 2010 to July 2022. The patients were divided into PVT and non-PVT groups based on the presence or absence of PVT, and relevant risk factors were analyzed. The management and prognosis of patients with PVT were investigated. Results:. Among the 1403 patients, PVT occurred in 33 cases, giving a frequency of 2.4%. In univariate analyses, female sex (P = 0.03), portal vein reconstruction (P = 0.01), and left lateral sectionectomy (P < 0.001) were significant risk factors for PVT. On multivariate analysis, portal vein reconstruction (P = 0.01) and left lateral segmentectomy (P < 0.001) remained significant risk factors for PVT. The management options for PVT were thrombectomy, antithrombotic therapy, and observation. With antithrombotic therapy, 96.4% of patients achieved PVT resolution. Among patients who underwent hepatectomy with portal vein reconstruction, the PVT site was the main trunk of the portal vein in all 3 cases, and thrombectomy was performed in 2 cases. No perioperative mortality was observed. Conclusions:. In the present study, portal vein reconstruction and left lateral sectionectomy were identified as risk factors for PVT after hepatectomy. As PVT can be fatal, early detection and appropriate treatment according to the status of PVT are important.http://journals.lww.com/10.1097/AS9.0000000000000523 |
| spellingShingle | Kazuki Wakizaka, MD, PhD Shunsuke Shichi, MD Takeshi Aiyama, MD, PhD Yoh Asahi, MD, PhD Akihisa Nagatsu, MD, PhD Tatsuya Orimo, MD, PhD Tatsuhiko Kakisaka, MD, PhD Akinobu Taketomi, MD, PhD Risk Factors and Management of Portal Vein Thrombosis after Hepatectomy: A Single-Center Experience Annals of Surgery Open |
| title | Risk Factors and Management of Portal Vein Thrombosis after Hepatectomy: A Single-Center Experience |
| title_full | Risk Factors and Management of Portal Vein Thrombosis after Hepatectomy: A Single-Center Experience |
| title_fullStr | Risk Factors and Management of Portal Vein Thrombosis after Hepatectomy: A Single-Center Experience |
| title_full_unstemmed | Risk Factors and Management of Portal Vein Thrombosis after Hepatectomy: A Single-Center Experience |
| title_short | Risk Factors and Management of Portal Vein Thrombosis after Hepatectomy: A Single-Center Experience |
| title_sort | risk factors and management of portal vein thrombosis after hepatectomy a single center experience |
| url | http://journals.lww.com/10.1097/AS9.0000000000000523 |
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