Hepatic veins as a site of clot formation following liver resection.
Pulmonary embolism occurs more frequently after hepatectomy than previously thought but is infrequently associated with peripheral deep vein thrombosis. In this paper, we report 2 cases of postoperative hepatic vein thrombosis after liver resection. Both patients had undergone major hepatectomy of a non-cirrhotic liver largely exposing the middle hepatic vein. Clots were incidentally found in the middle hepatic vein 4 and 17 d after surgery despite routine systemic thrombo-prophylaxis with low molecular weight heparin. Coagulation of the transition plan in a context of mutation of the prothrombin gene and inflammation induced biloma were the likely predisposing conditions. Clots disappeared following curative anticoagulation. We conclude that thrombosis of hepatic veins may occur after liver resection and is a potential source of pulmonary embolism.
Department of Hepato-Biliary Surgery, Hôpital Beaujon, Assistance-Publique Hôpitaux de Paris, University Paris 7, 92118 Clichy, France.
Emmanuel
E
Buc
Safi
S
Dokmak
Magaly
M
Zappa
Marie Helene
MH
Denninger
Dominique Charles
DC
Valla
Jacques
J
Belghiti
Olivier
O
Farges
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006503:Hepatic Veins / Q000473:pathology*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000097:blood*; D020246:Venous Thrombosis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology
D000925:Anticoagulants
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