Portal vein thrombosis after reconstruction in 270 consecutive patients with portal vein resections in hepatopancreatobiliary (HPB) surgery

Miyazaki, Masaru; Shimizu, Hiroaki; Ohtuka, Masayuki; Kato, Atsushi; Furukawa, Katsunori; Takayashiki, Tsukasa; Kuboki, Satoshi; Takano, Shigetsugu; Suzuki, Daisuke; Higashihara, Taku

doi:10.1016/j.amjsurg.2016.12.008

Cited by 13 publications

(6 citation statements)

References 18 publications

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“…In fact, only one patient died consecutive to this complication which at his turn was determined by portal thrombosis. Miyazaki et al showed that portal vein thrombosis after portal resection occur more frequently after hepatectomy than after pancreatectomy, and also that the restoration of portal vein blood flow was more efficiently achieved when re-operation was performed within 3 days after surgery (29). In our patient portal thrombectomy was performed 24 hours after the first operation, but the patient still developed liver failure and subsequently died 4 days later.…”

Section: Discussionmentioning

confidence: 53%

Extension of Hepatic Resection Ameliorates Survival in Patients with Type IIIa or IIIb Klatskin Tumors Despite Surgical Complications

Scurtu¹,

Dindelegan²,

Bințințan³

et al. 2017

chr

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Introducere: Hepatectomiile majore efectuate pentru colangiocarcinom hilar (HC) sunt încă asociate cu o morbiditate şi mortalitate postoperatorie crescute. Scopul acestei lucrări a fost de a evalua dacă şi cum este influenţată supravieţuirea pacienţilor cu HC tip III si IV conform clasificării Bismuth-Corlette, de complicaţiile semnificative survenite după hepatectomii extinse. Material şi metodă: Au fost evaluate retrospectiv dosarele medicale ale pacienţilor cu hepatectomii majore pentru HC urmate de complicaţii. Doar pacienţii cu urmărire postoperatorie completă au fost incluşi în studiu. Au fost urmărite morbiditatea şi mortalitatea postoperatorie, durata de spitalizare, supravieţuirea şi intervalul liber de boală. Rezultate: Doar cinci pacienţi au corespuns criteriilor de includere în studiu. Trei pacienţi au necesitat reintervenţie chirurgicală, cu un deces pe durata spitalizării. Doi pacienţi sunt încă în urmărire, ceilalţi decedînd prin recidivă tumorală, după un interval liber de boală de 36, respectiv 49 de luni. Durata medie actualizată de supravieţuire a fost de 30 luni, iar intervalul liber mediu de boală a fost de 26 luni. Concluzii: La pacienţii cu HC hepatectomiile extinse au un beneficiu clar pentru supravieţuire, dar se asociaza cu o morbiditate şi mortalitate postoperatorie crescute. Tratate cu succes, complicaţiile postoperatorii nu influenţează semnificativ supravieţuirea pe termen lung.

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Section: Discussionmentioning

confidence: 53%

Extension of Hepatic Resection Ameliorates Survival in Patients with Type IIIa or IIIb Klatskin Tumors Despite Surgical Complications

Scurtu¹,

Dindelegan²,

Bințințan³

et al. 2017

chr

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“…Usual tubular grafts include prosthetic material (generally PTFE), biological grafts such as cryopreserved venous allograft or bovine pericardium, and autologous veins (mostly renal, iliac, saphenous, or jugular veins). The main disadvantages related to these techniques and materials include high cost, risk of graft infection, low availability, long‐term anticoagulation, need for additional visceral dissection or incisions, longer operative time, among others 8–13 …”

Section: Discussionmentioning

confidence: 99%

“…A range of materials, synthetic or biological, has been used as venous substitutes. Tubular graft options include synthetic grafts (such as polytetrafluoroethylene—PTFE), autologous veins (such as left renal, saphenous, iliac, and internal jugular veins), cadaveric veins cryopreserved, and bovine pericardium 8–14 . Main concerns with the use of these sources include the risk of graft infection (mainly in synthetic grafts) and the need for additional incisions or visceral dissection to harvest autologous veins.…”

Section: Introductionmentioning

confidence: 99%

“…Tubular graft options include synthetic grafts (such as polytetrafluoroethylene-PTFE), autologous veins (such as left renal, saphenous, iliac, and internal jugular veins), cadaveric veins cryopreserved, and bovine pericardium. [8][9][10][11][12][13][14] Main concerns with the use of these sources include the risk of graft infection (mainly in synthetic grafts) and the need for additional incisions or visceral dissection to harvest autologous veins. Also, in cases where venous resection was not predicted preoperatively some of these options may not be promptly available.…”

Section: Introductionmentioning

confidence: 99%

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Falciform ligament tubular graft for mesenteric‐portal vein reconstruction during pancreaticoduodenectomy

Balzan

Gava

Rieger

et al. 2021

Journal of Surgical Oncology

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Background Portal vein resection and reconstruction in locally advanced pancreatic cancer represents a potentially curative treatment in selected patients without increasing surgical mortality. However, vascular reconstruction after segmental venous resection is challenging. The parietal peritoneum has emerged as a venous substitute but few reports include its use as a tubular graft. We report a retrospective series of portal vein reconstruction using a falciform ligament tubular graft during pancreaticoduodenectomy. Material and Methods Technical aspects and short‐term morbidity and mortality after pancreaticoduodenectomy with falciform ligament tubular graft interposition were analyzed. Results Among 21 patients who used parietal peritoneum for venous substitution between 2015 and 2019, eight underwent pancreaticoduodenectomy with venous resection and reconstruction using interposition of falciform ligament tubular graft. The mean duration of surgery and clamping time were 350 and 27 min, respectively. No perioperative blood transfusion was required. All the grafts were patent the day after surgery. No complication related to venous obstruction was detected during the hospital stay. Two patients had postoperative pancreatic fistula. No further intervention was needed. The 90‐day mortality was null. Conclusions The use of interposition of falciform ligament tubular graft for portal venous reconstruction during pancreaticoduodenectomy seems to be a reliable, inexpensive, and safe procedure.

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“…2,3 Local factors include thrombosis in patients with history of catheterization of the umbilical veins during the neonatal period, abdominal blunt and penetrating trauma, inflammatory conditions with injury to the intestine, pancreas, liver or spleen, extrinsic compression by tumors, and abdominal surgery. [4][5][6][7][8][9][10][11][12] Portal vein thrombosis (PVT) has also been described in patients with hepatocellular carcinoma and liver cirrhosis. 2,13 The risk of developing PVT is higher in patients with cirrhosis, compared with the general population 2 .…”

mentioning

confidence: 99%

Diagnosis and Management of Acute and Chronic Portomesenteric Venous Thrombosis

Ferral¹

2022

Digestive Disease Interventions

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Thrombosis of the portal and mesenteric veins is relatively uncommon. Thrombosis can be acute or chronic. Management is dictated by symptoms on clinical presentation. Acute symptomatic mesenteric vein thrombosis may require aggressive endovascular intervention with mechanical thrombectomy, thromboaspiration, infusion of thrombolytic drugs, TIPS creation or surgery. Chronic, symptomatic portal and mesenteric vein thrombosis usually requires recanalization of occluded segments and stent placement. The three main catheterization techniques for access into the portal venous system are: transhepatic, transjugular and trans-splenic. Evidence-based therapeutic strategies for acute and chronic portal and mesenteric vein thrombosis have not been established. There are no prospective comparative studies to support superiority of any given technique in the management of these conditions. The purpose of this review is to present an overview of the etiology, physiopathology, clinical presentation, and management of acute and chronic portal and mesenteric vein thrombosis.

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Portal vein thrombosis after reconstruction in 270 consecutive patients with portal vein resections in hepatopancreatobiliary (HPB) surgery

Cited by 13 publications

References 18 publications

Extension of Hepatic Resection Ameliorates Survival in Patients with Type IIIa or IIIb Klatskin Tumors Despite Surgical Complications

Extension of Hepatic Resection Ameliorates Survival in Patients with Type IIIa or IIIb Klatskin Tumors Despite Surgical Complications

Falciform ligament tubular graft for mesenteric‐portal vein reconstruction during pancreaticoduodenectomy

Diagnosis and Management of Acute and Chronic Portomesenteric Venous Thrombosis

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