New classification-oriented treatment strategy for portal vein thrombosis after hepatectomy.
anticoagulants
hepatectomy
multidetector computed tomography
portal vein
venous thrombosis
Journal
Annals of gastroenterological surgery
ISSN: 2475-0328
Titre abrégé: Ann Gastroenterol Surg
Pays: Japan
ID NLM: 101718062
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
30
05
2020
revised:
21
06
2020
accepted:
10
07
2020
entrez:
15
12
2020
pubmed:
16
12
2020
medline:
16
12
2020
Statut:
epublish
Résumé
This study sought to evaluate the incidence, risk factors, and clinical outcomes of portal vein thrombosis after hepatectomy. Furthermore, we proposed a novel classification and treatment strategy for portal vein thrombosis after hepatectomy. We retrospectively analyzed 398 patients who underwent hepatectomy and enhanced computed tomography imaging within 14 days after surgery in our hospital from 2009 to 2019. Portal vein thrombosis was classified into three categories according to the location of the thrombus - main, hilar, and peripheral - with main portal vein thrombosis further subclassified into three grades. Each patient's treatment strategy was determined based on their portal vein thrombosis classification and grading. From 2015, enhanced computed tomography imaging was performed routinely on patients who underwent anatomical hepatectomy on postoperative day 7. Portal vein thrombosis was diagnosed in 57 patients (14.3%) during the study period. Multivariate analysis revealed that a Pringle maneuver time of 75 minutes or longer was a significant predictor of portal vein thrombosis ( Patients who undergo hepatectomy are at high risk for portal vein thrombosis, especially when the Pringle maneuver time is long. The proposed classification and treatment strategy may be useful for clinical management of patients with portal vein thrombosis after hepatectomy.
Identifiants
pubmed: 33319161
doi: 10.1002/ags3.12383
pii: AGS312383
pmc: PMC7726684
doi:
Types de publication
Journal Article
Langues
eng
Pagination
701-709Informations de copyright
© 2020 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterology.
Déclaration de conflit d'intérêts
Conflict of Interest: The authors declare no conflict of interest for this article. Author Contribution: Conception and design of the study, analysis and interpretation of data, collection and assembly of data, drafting of the article: Shinji Onda. Analysis and interpretation of data, collection of data: Kenei Furukawa, Yoshihiro Shirai. Collection of data: Ryoga Hamura, Takashi Horiuchi, Jungo Yasuda, Hironori Shiozaki, Takeshi Gocho, Hioaki Shiba. Critical revision of the article: Toru Ikegami.
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