Clinical analysis of the treatment of acute portal vein thrombosis after hepatectomy
10.3760/cma.j.cn115396-20231018-00092
- VernacularTitle:肝切除术后急性门静脉血栓形成的临床分析
- Author:
Qingyun ZHOU
1
;
Kun ZHANG
;
Jinde ZHU
;
Chaoyong TU
Author Information
1. 浙江省丽水市中心医院肝胆胰外科，丽水 323000
- Keywords:
Hepatectomy;
Portal vein;
Venous thrombosis;
Diagnosis;
Treatment;
Acute portal vein thrombosis
- From:
International Journal of Surgery
2023;50(12):841-845
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical manifestations, diagnosis and treatment methods, and prognosis of acute portal vein thrombosis after hepatectomy.Methods:Retrospective case analysis was used in the case data of 11 patients with acute portal vein thrombosis after hepatectomy, who were treated in Lishui Central Hospital of Zhejiang Province from January 2018 to August 2023, including their demographic characteristics, clinical manifestations, test results, imaging examinations, treatment plans, and prognosis.Results:The diagnostic time of PVT was 4-15 days after surgery. 5 cases were main portal vein thrombosis, including 2 cases who were accumulated splenic vein and superior mesenteric vein, and 6 cases were portal vein branch thrombosis. 2 cases had fever, 3 cases had abdominal distension, 3 cases had ascites, and 5 cases had no obvious clinical symptoms. Patients may experience elevated bilirubin, elevated transaminase, prolonged prothrombin time, and elevated D-2 dimer levels during PVT. 10 cases were diagnosed through CT enhancement, and 1 case was first diagnosed through ultrasound examination. 11 patients who diagnosed with PVT were received anticoagulant therapy, with 6 patients receiving a combination of circulatory improvement drugs. One patient progressed to liver failure, and 10 patients had thrombus disappearance, who were receivedsatisfactory clinical efficacy.Conclusions:Early detections and treatments are the key to treating the acute PVT after hepatectomy. If possible, anticoagulant therapy should be used as soon as possible after surgery. For main grade 3 portal vein thrombosis, early surgical thrombectomy should be considered. At present, there is a lack of effective prevention and prediction methods for acute PVTafter hepatectomy, and thefurther research and exploration are needed.
