Portal vein thrombosis after right hepatectomy: impact of portal vein resection and morphological changes of the portal vein. Issue 7 (July 2022)

• Record Type: Journal Article
• Authors: Terasaki, Fumihiro; Ohgi, Katsuhisa; Sugiura, Teiichi; Okamura, Yukiyasu; Ito, Takaaki; Yamamoto, Yusuke; Ashida, Ryo; Yamada, Mihoko; Otsuka, Shimpei; Aramaki, Takeshi; Uesaka, Katsuhiko
• Is Part Of: HPB. Volume 24:Issue 7(2022)
• Page Start: 1129
• Page End: 1137
• Publication Date: 2022-07
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2021.12.004
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: Right hepatectomy occasionally requires portal vein resection (PVR) and causes postoperative portal vein thrombosis (PVT). Methods: A total of 247 patients who underwent right hepatectomy were evaluated using a three-dimensional analyzer to identify the morphologic changes in the portal vein (PV). The patients' characteristics were compared between the PVR group (n = 73) and non-PVR group (n = 174), and risk factors for PVT were investigated. The PVR group were subdivided into the wedge resection (WR) group (n = 38) and segmental resection (SR) group (n= 35). Results: Postoperative PVT occurred in 20 patients (8.1%). Multivariate analyses in all patients revealed that postoperative left PV diameter/main PV diameter (L/M ratio) <0.56 (odds ratio [OR] 4.00, p = 0.009) and PVR (OR 3.31, p = 0.031) were significant risk factors for PVT. In 73 patients who underwent PVR, PVT occurred in 14 (19%) and WR (OR 11.5, p = 0.005) and L/M ratio <0.56 (OR 5.51, p = 0.016) were significant risk factors for PVT. Conclusion : PVR was one of the significant risk factors for PVT after right hepatectomy. SR rather than WR may be recommended for preventing PVT.