Early portal vein thrombosis after hepatectomy for perihilar cholangiocarcinoma: Incidence, risk factors, and management

Cholangiocarcinoma is a rare, aggressive biliary tract malignancy representing only 3% of digestive cancers worldwide. Late diagnosis is common, which results in less than one-third of patients being eligible for surgical resection or liver transplantation. Surgery, however, is not without associated morbidity and mortality. This article seeks to review minimally invasive techniques for the management of complications following liver transplantation and hepatic resection for patients with cholangiocarcinoma.

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Risk Factors and Management of Portal Vein Thrombosis after Hepatectomy: A Single-Center Experience

Wakizaka,

Shichi,

Aiyama

et al. 2024

Annals of Surgery Open

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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.

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Early portal vein thrombosis after hepatectomy for perihilar cholangiocarcinoma: Incidence, risk factors, and management

Cited by 3 publications

References 23 publications

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Minimally Invasive Management of Postoperative Complications in Patients with Cholangiocarcinoma

Risk Factors and Management of Portal Vein Thrombosis after Hepatectomy: A Single-Center Experience

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