Incidence, risk factors, and management options for portal vein thrombosis after hepatectomy: a 14-year, single-center experience
Abstract Background Portal vein thrombosis (PVT) after hepatectomy is rare; however, it increases mortality and morbidity. Few studies have been conducted that focused on PVT following major hepatectomy. Methods Patients who underwent hepatectomy at a single institution were retrospectively reviewed...
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| creator | Kuboki, Satoshi, M.D Shimizu, Hiroaki, M.D Ohtsuka, Masayuki, M.D Kato, Atsushi, M.D Yoshitomi, Hideyuki, M.D Furukawa, Katsunori, M.D Takayashiki, Tsukasa, M.D Takano, Shigetsugu, M.D Okamura, Daiki, M.D Suzuki, Daisuke, M.D Sakai, Nozomu, M.D Kagawa, Shingo, M.D Miyazaki, Masaru, M.D |
| description | Abstract Background Portal vein thrombosis (PVT) after hepatectomy is rare; however, it increases mortality and morbidity. Few studies have been conducted that focused on PVT following major hepatectomy. Methods Patients who underwent hepatectomy at a single institution were retrospectively reviewed, and risk factors and management options were evaluated. Results Of the 1,193 patients undergoing hepatectomy, 25 patients developed PVT. Right-sided hepatectomy, caudate lobectomy, splenectomy, and postoperative bile leakage were independent risk factors for PVT following hepatectomy. PVT occurred more frequently after major hepatectomy compared with minor hepatectomy. Increased instability and reduced portal venous flow caused by kinking was the reason for increasing the risk of PVT after right-sided hepatectomy with caudate lobectomy. The new operative procedure, suturing the posterior wall of the portal vein with the anterior wall of the inferior vena cava, was effective for reducing the risk of PVT following right-sided hepatectomy. Operative thrombectomy showed significant benefits for PVT detected within 5 days after hepatectomy. Conclusions PVT frequently occurs following major hepatectomy. Urgent operative thrombectomy is strongly recommended for PVT with early detection. |
| doi_str_mv | 10.1016/j.amjsurg.2014.11.021 |
| format | Article |
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Few studies have been conducted that focused on PVT following major hepatectomy. Methods Patients who underwent hepatectomy at a single institution were retrospectively reviewed, and risk factors and management options were evaluated. Results Of the 1,193 patients undergoing hepatectomy, 25 patients developed PVT. Right-sided hepatectomy, caudate lobectomy, splenectomy, and postoperative bile leakage were independent risk factors for PVT following hepatectomy. PVT occurred more frequently after major hepatectomy compared with minor hepatectomy. Increased instability and reduced portal venous flow caused by kinking was the reason for increasing the risk of PVT after right-sided hepatectomy with caudate lobectomy. The new operative procedure, suturing the posterior wall of the portal vein with the anterior wall of the inferior vena cava, was effective for reducing the risk of PVT following right-sided hepatectomy. Operative thrombectomy showed significant benefits for PVT detected within 5 days after hepatectomy. Conclusions PVT frequently occurs following major hepatectomy. Urgent operative thrombectomy is strongly recommended for PVT with early detection.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2014.11.021</identifier><identifier>PMID: 26307424</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abdomen ; Abdominal Pain - etiology ; Anticoagulants - therapeutic use ; Bile ; Blood clots ; Caudate lobectomy ; Confidence intervals ; Female ; Fever - etiology ; Fibrin Fibrinogen Degradation Products - analysis ; Fibrinogen - analysis ; Hepatectomy - adverse effects ; Hepatectomy - methods ; Humans ; Hyperammonemia - etiology ; Hypertension ; Incidence ; Liver - pathology ; Liver cirrhosis ; Major hepatectomy ; Male ; Middle Aged ; Mortality ; Multivariate analysis ; Necrosis - etiology ; Operative thrombectomy ; Patients ; Portal Vein - surgery ; Portal vein thrombosis ; Retrospective Studies ; Right-sided hepatectomy ; Risk Factors ; Software ; Spleen ; Splenectomy - adverse effects ; Surgery ; Thrombectomy ; Thrombosis ; Veins & arteries ; Vena Cava, Inferior - surgery ; Venous Thrombosis - diagnosis ; Venous Thrombosis - etiology ; Venous Thrombosis - therapy</subject><ispartof>The American journal of surgery, 2015-11, Vol.210 (5), p.878-885.e2</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Nov 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c514t-f919ccc320d483dccadaed2deab01d2d3d1580d6949eaa5611a1280dbaf61fcd3</citedby><cites>FETCH-LOGICAL-c514t-f919ccc320d483dccadaed2deab01d2d3d1580d6949eaa5611a1280dbaf61fcd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1722479807?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974,64362,64364,64366,72216</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26307424$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kuboki, Satoshi, M.D</creatorcontrib><creatorcontrib>Shimizu, Hiroaki, M.D</creatorcontrib><creatorcontrib>Ohtsuka, Masayuki, M.D</creatorcontrib><creatorcontrib>Kato, Atsushi, M.D</creatorcontrib><creatorcontrib>Yoshitomi, Hideyuki, M.D</creatorcontrib><creatorcontrib>Furukawa, Katsunori, M.D</creatorcontrib><creatorcontrib>Takayashiki, Tsukasa, M.D</creatorcontrib><creatorcontrib>Takano, Shigetsugu, M.D</creatorcontrib><creatorcontrib>Okamura, Daiki, M.D</creatorcontrib><creatorcontrib>Suzuki, Daisuke, M.D</creatorcontrib><creatorcontrib>Sakai, Nozomu, M.D</creatorcontrib><creatorcontrib>Kagawa, Shingo, M.D</creatorcontrib><creatorcontrib>Miyazaki, Masaru, M.D</creatorcontrib><title>Incidence, risk factors, and management options for portal vein thrombosis after hepatectomy: a 14-year, single-center experience</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background Portal vein thrombosis (PVT) after hepatectomy is rare; however, it increases mortality and morbidity. Few studies have been conducted that focused on PVT following major hepatectomy. Methods Patients who underwent hepatectomy at a single institution were retrospectively reviewed, and risk factors and management options were evaluated. Results Of the 1,193 patients undergoing hepatectomy, 25 patients developed PVT. Right-sided hepatectomy, caudate lobectomy, splenectomy, and postoperative bile leakage were independent risk factors for PVT following hepatectomy. PVT occurred more frequently after major hepatectomy compared with minor hepatectomy. Increased instability and reduced portal venous flow caused by kinking was the reason for increasing the risk of PVT after right-sided hepatectomy with caudate lobectomy. The new operative procedure, suturing the posterior wall of the portal vein with the anterior wall of the inferior vena cava, was effective for reducing the risk of PVT following right-sided hepatectomy. Operative thrombectomy showed significant benefits for PVT detected within 5 days after hepatectomy. Conclusions PVT frequently occurs following major hepatectomy. Urgent operative thrombectomy is strongly recommended for PVT with early detection.</description><subject>Abdomen</subject><subject>Abdominal Pain - etiology</subject><subject>Anticoagulants - therapeutic use</subject><subject>Bile</subject><subject>Blood clots</subject><subject>Caudate lobectomy</subject><subject>Confidence intervals</subject><subject>Female</subject><subject>Fever - etiology</subject><subject>Fibrin Fibrinogen Degradation Products - analysis</subject><subject>Fibrinogen - analysis</subject><subject>Hepatectomy - adverse effects</subject><subject>Hepatectomy - methods</subject><subject>Humans</subject><subject>Hyperammonemia - etiology</subject><subject>Hypertension</subject><subject>Incidence</subject><subject>Liver - pathology</subject><subject>Liver cirrhosis</subject><subject>Major hepatectomy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Necrosis - etiology</subject><subject>Operative thrombectomy</subject><subject>Patients</subject><subject>Portal Vein - surgery</subject><subject>Portal vein thrombosis</subject><subject>Retrospective Studies</subject><subject>Right-sided hepatectomy</subject><subject>Risk Factors</subject><subject>Software</subject><subject>Spleen</subject><subject>Splenectomy - adverse effects</subject><subject>Surgery</subject><subject>Thrombectomy</subject><subject>Thrombosis</subject><subject>Veins & arteries</subject><subject>Vena Cava, Inferior - surgery</subject><subject>Venous Thrombosis - diagnosis</subject><subject>Venous Thrombosis - etiology</subject><subject>Venous Thrombosis - therapy</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFks9u1DAQxiMEotvCI4AsceGwWTyOk004gFDFn0qVOABna9aebJ0mdrCzFXvlSfosPBlOdwGpF04jW7_5xv6-ybJnwFfAoXrVrXDo4i5sV4KDXAGsuIAH2QLqdZNDXRcPswXnXORNBfwkO42xS0cAWTzOTkRV8LUUcpH9vHDaGnKalizYeM1a1JMPccnQGTagwy0N5Cbmx8l6F1nrAxt9mLBnN2Qdm66CHzY-2siwnSiwKxpxoiQy7F8z_HULMt8ThiWL1m17ynVSSxj9GCnYefCT7FGLfaSnx3qWffvw_uv5p_zy88eL83eXuS5BTnnbQKO1LgQ3si6M1miQjDCEGw6pFgbKmpuqkQ0hlhUAgkgXG2wraLUpzrKXB90x-O87ipMabNTU9-jI76KCtRCNkFW9TuiLe2jnd8Gl191Rct3UfKbKA6WDjzFQq8ZgBwx7BVzNIalOHUNSc0gKQKWQUt_zo_puM5D52_UnlQS8PQCU7LixFFTUd1YZG5Kzynj73xFv7ino3jqrsb-mPcV_v1FRKK6-zJsyLwqUnEtoyuI3ebK9VA</recordid><startdate>20151101</startdate><enddate>20151101</enddate><creator>Kuboki, Satoshi, M.D</creator><creator>Shimizu, Hiroaki, M.D</creator><creator>Ohtsuka, Masayuki, M.D</creator><creator>Kato, Atsushi, M.D</creator><creator>Yoshitomi, Hideyuki, M.D</creator><creator>Furukawa, Katsunori, M.D</creator><creator>Takayashiki, Tsukasa, M.D</creator><creator>Takano, Shigetsugu, M.D</creator><creator>Okamura, Daiki, M.D</creator><creator>Suzuki, Daisuke, M.D</creator><creator>Sakai, Nozomu, M.D</creator><creator>Kagawa, Shingo, M.D</creator><creator>Miyazaki, Masaru, M.D</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20151101</creationdate><title>Incidence, risk factors, and management options for portal vein thrombosis after hepatectomy: a 14-year, single-center experience</title><author>Kuboki, Satoshi, M.D ; Shimizu, Hiroaki, M.D ; Ohtsuka, Masayuki, M.D ; Kato, Atsushi, M.D ; Yoshitomi, Hideyuki, M.D ; Furukawa, Katsunori, M.D ; Takayashiki, Tsukasa, M.D ; Takano, Shigetsugu, M.D ; Okamura, Daiki, M.D ; Suzuki, Daisuke, M.D ; Sakai, Nozomu, M.D ; Kagawa, Shingo, M.D ; Miyazaki, Masaru, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c514t-f919ccc320d483dccadaed2deab01d2d3d1580d6949eaa5611a1280dbaf61fcd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Abdomen</topic><topic>Abdominal Pain - etiology</topic><topic>Anticoagulants - therapeutic use</topic><topic>Bile</topic><topic>Blood clots</topic><topic>Caudate lobectomy</topic><topic>Confidence intervals</topic><topic>Female</topic><topic>Fever - etiology</topic><topic>Fibrin Fibrinogen Degradation Products - analysis</topic><topic>Fibrinogen - analysis</topic><topic>Hepatectomy - adverse effects</topic><topic>Hepatectomy - methods</topic><topic>Humans</topic><topic>Hyperammonemia - etiology</topic><topic>Hypertension</topic><topic>Incidence</topic><topic>Liver - pathology</topic><topic>Liver cirrhosis</topic><topic>Major hepatectomy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Necrosis - etiology</topic><topic>Operative thrombectomy</topic><topic>Patients</topic><topic>Portal Vein - surgery</topic><topic>Portal vein thrombosis</topic><topic>Retrospective Studies</topic><topic>Right-sided hepatectomy</topic><topic>Risk Factors</topic><topic>Software</topic><topic>Spleen</topic><topic>Splenectomy - adverse effects</topic><topic>Surgery</topic><topic>Thrombectomy</topic><topic>Thrombosis</topic><topic>Veins & arteries</topic><topic>Vena Cava, Inferior - surgery</topic><topic>Venous Thrombosis - diagnosis</topic><topic>Venous Thrombosis - etiology</topic><topic>Venous Thrombosis - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kuboki, Satoshi, M.D</creatorcontrib><creatorcontrib>Shimizu, Hiroaki, M.D</creatorcontrib><creatorcontrib>Ohtsuka, Masayuki, M.D</creatorcontrib><creatorcontrib>Kato, Atsushi, M.D</creatorcontrib><creatorcontrib>Yoshitomi, Hideyuki, M.D</creatorcontrib><creatorcontrib>Furukawa, Katsunori, M.D</creatorcontrib><creatorcontrib>Takayashiki, Tsukasa, M.D</creatorcontrib><creatorcontrib>Takano, Shigetsugu, M.D</creatorcontrib><creatorcontrib>Okamura, Daiki, M.D</creatorcontrib><creatorcontrib>Suzuki, Daisuke, M.D</creatorcontrib><creatorcontrib>Sakai, Nozomu, M.D</creatorcontrib><creatorcontrib>Kagawa, Shingo, M.D</creatorcontrib><creatorcontrib>Miyazaki, Masaru, M.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kuboki, Satoshi, M.D</au><au>Shimizu, Hiroaki, M.D</au><au>Ohtsuka, Masayuki, M.D</au><au>Kato, Atsushi, M.D</au><au>Yoshitomi, Hideyuki, M.D</au><au>Furukawa, Katsunori, M.D</au><au>Takayashiki, Tsukasa, M.D</au><au>Takano, Shigetsugu, M.D</au><au>Okamura, Daiki, M.D</au><au>Suzuki, Daisuke, M.D</au><au>Sakai, Nozomu, M.D</au><au>Kagawa, Shingo, M.D</au><au>Miyazaki, Masaru, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence, risk factors, and management options for portal vein thrombosis after hepatectomy: a 14-year, single-center experience</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2015-11-01</date><risdate>2015</risdate><volume>210</volume><issue>5</issue><spage>878</spage><epage>885.e2</epage><pages>878-885.e2</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Abstract Background Portal vein thrombosis (PVT) after hepatectomy is rare; however, it increases mortality and morbidity. Few studies have been conducted that focused on PVT following major hepatectomy. Methods Patients who underwent hepatectomy at a single institution were retrospectively reviewed, and risk factors and management options were evaluated. Results Of the 1,193 patients undergoing hepatectomy, 25 patients developed PVT. Right-sided hepatectomy, caudate lobectomy, splenectomy, and postoperative bile leakage were independent risk factors for PVT following hepatectomy. PVT occurred more frequently after major hepatectomy compared with minor hepatectomy. Increased instability and reduced portal venous flow caused by kinking was the reason for increasing the risk of PVT after right-sided hepatectomy with caudate lobectomy. The new operative procedure, suturing the posterior wall of the portal vein with the anterior wall of the inferior vena cava, was effective for reducing the risk of PVT following right-sided hepatectomy. Operative thrombectomy showed significant benefits for PVT detected within 5 days after hepatectomy. Conclusions PVT frequently occurs following major hepatectomy. Urgent operative thrombectomy is strongly recommended for PVT with early detection.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26307424</pmid><doi>10.1016/j.amjsurg.2014.11.021</doi></addata></record> |
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| subjects | Abdomen Abdominal Pain - etiology Anticoagulants - therapeutic use Bile Blood clots Caudate lobectomy Confidence intervals Female Fever - etiology Fibrin Fibrinogen Degradation Products - analysis Fibrinogen - analysis Hepatectomy - adverse effects Hepatectomy - methods Humans Hyperammonemia - etiology Hypertension Incidence Liver - pathology Liver cirrhosis Major hepatectomy Male Middle Aged Mortality Multivariate analysis Necrosis - etiology Operative thrombectomy Patients Portal Vein - surgery Portal vein thrombosis Retrospective Studies Right-sided hepatectomy Risk Factors Software Spleen Splenectomy - adverse effects Surgery Thrombectomy Thrombosis Veins & arteries Vena Cava, Inferior - surgery Venous Thrombosis - diagnosis Venous Thrombosis - etiology Venous Thrombosis - therapy |
| title | Incidence, risk factors, and management options for portal vein thrombosis after hepatectomy: a 14-year, single-center experience |
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