[Application of eversion embolectomy for portal vein thrombosis on liver transplantation].
OBJECTIVE
To discuss the technical improvement of the conventional thrombectomy for portal vein thrombosis (PVT) on liver transplantation.


METHODS
The clinical data of 198 cases of liver transplantation with PVT who admitted in Tianjin First Central Hospital were analyzed retrospectively. According to the different treatments for PVT, these cases were divided into group A and group B. The conventional eversion embolectomy were performed in group A (n = 43) and the improved eversion embolectomy were performed in group B (n = 155). The general conditions, blood loss volumes, the achievement ratio of embolectomy, PVT recurrence rate and survival rate between the two groups were compared.


RESULTS
No statistical significance on operation time between two groups (P > 0.05); the achievement ratio of embolectomy for Yerdel I-II were 100% in two groups, however, the achievement ratio of embolectomy for Yerdel III in group B was higher than that of group A (100% vs. 45.45%; chi(2) = 12.38, P < 0.01). Blood loss volumes in group B was significantly lower than that of group A [(4315.4 +/- 630.5) ml vs. (3509.2 +/- 862.7) ml, P < 0.05]. No statistical significance on Yerdel I and II PVT recurrence rate between two groups (P > 0.05). While thrombosis recurrent rate of Yerdel III PVT in group B was lower than that of group A(5.6% vs. 2/5; chi(2) = 4.09, P < 0.05). Perioperative mortality of Yerdel I-III patients were both 0 in two groups. 1-year survival rate of Yerdel I-III patients was similar in two groups (86.5% vs. 89.0%, P > 0.05).


CONCLUSIONS
Improved eversion embolectomy can simplify the operation procedures, reduce blood loss, expand application range, increase the embolectomy success rate, decrease the PVT relapse rate.
Department of Transplant Surgery, Tianjin First Central Hospital, Tianjin 300192, China. pancheng@ootc.net
Cheng
C
Pan
Yuan
Y
Shi
Yong-lin
YL
Deng
Hong
H
Zheng
Zhi-jun
ZJ
Zhu
Zhong-yang
ZY
Shen
D000328:Adult; D000368:Aged; D017128:Embolectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000601:surgery*