Introduction: Patients after liver surgery are classified into the high-risk group for deep vein thrombosis (DVT) and pulmonary embolism (PE) according to the Japanese guidelines. However, few reports have mentioned about pharmacologic thromboprophylaxis and postoperative thrombotic complications after liver surgery. Methods: From September 2015 to August 2017, 113 patients underwent postoperative pharmacologic thromboprophylaxis with enoxaparin after liver surgery. Of these, 60 patients with postoperative enhanced CT during the hospital stay were included and estimated about thrombotic complications.Results: The patients were 44 males and 16 females with a median age of 72 years. Enoxaparin was administered in 49 patients (82%), heparin in 1 patient (1.7%) and none in 10 patients (17%). 10 patients (17%) had postoperative thrombotic complications (DVT/PE in 1 patient, thrombosis of the internal jugular vein in 1 patient, inferior vena cava in 1 patient and portal vein in 7 patients) with no clinical symptoms. Postoperative pharmacologic thromboprophylaxis reduced thrombotic complications (P=0.083). On the other hand, 4 patients had adverse events (bleeding through placed abdominal drains in 3 patients, thrombocytopenia in 1 patient) and all were improved after stopping administration. Assessing perioperative factors, preoperative chemotherapy increased the risk (P=0.083) and preoperative serum albumin, intraoperative blood loss, postoperative total bilirubin were significantly higher (P=0.02/0.037/0.066) and prothrombin percentage activity was significantly lower (P=0.0006) in patients with thrombotic complications. Antithrombotic drugs were administered and thrombosis regressed in all complicated patients. Conclusion: Further investigation in more patients will reveal individual appropriate prevention and treatment for thrombotic complications after liver surgery.
considered as contraindication to LT. There was no difference in post-operative PVT recurrence (no PVT 7.4% vs PVT 13.3%,p=0.351). While re-operation was more common in PVT group (no PVT 10.2% vs PVT 33.3%, p=0.027), none were related to PVT recurrence. Median duration of follow-up for no PVT and PVT groups were 78.0 months (1.0-106.0 months) and 82.0 months (63.0-97.0 months) respectively. 5-year OS was comparable between both groups (no PVT 91.4% vs PVT 100.0%, p=0.203).
Conclusion:Yerdel grade 1 to 3 PVT does not affect LT outcomes and LT can be safely performed in patients with PVT in a medium-sized LT center.
considered as contraindication to LT. There was no difference in post-operative PVT recurrence (no PVT 7.4% vs PVT 13.3%,p=0.351). While re-operation was more common in PVT group (no PVT 10.2% vs PVT 33.3%, p=0.027), none were related to PVT recurrence. Median duration of follow-up for no PVT and PVT groups were 78.0 months (1.0-106.0 months) and 82.0 months (63.0-97.0 months) respectively. 5-year OS was comparable between both groups (no PVT 91.4% vs PVT 100.0%, p=0.203).
Conclusion:Yerdel grade 1 to 3 PVT does not affect LT outcomes and LT can be safely performed in patients with PVT in a medium-sized LT center.
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