title: Acute iatrogenic Budd-Chiari syndrome following hepatectomy for hepatolithiasis: a report of two cases.
abstract: Budd-Chiari syndrome (BCS) is defined as hepatic venous outflow obstruction at any level from the small hepatic veins to the junction of the inferior vena cava (IVC) and the right atrium, regardless of the cause of obstruction. We present two cases of acute iatrogenic BCS and our clinical management of these cases. The first case was a 43-year-old woman who developed acute BCS following the implantation of an IVC stent for the correction of stenosis in the IVC after hepatectomy for hepatolithiasis. The second case was a 61-year-old woman with complete obstruction of the outflow of hepatic veins during bilateral hepatectomy for hepatolithiasis. Acute iatrogenic BCS should be considered a rare complication following hepatectomy for hepatolithiasis. Awareness of potential hepatic outflow obstructions and timely management are critical to avoid poor outcomes when performing hepatectomy for hepatolithiasis.
authors.affiliation: Xue-Li Bai, Yi-Wen Chen, Qi Zhang, Long-Yun Ye, Yuan-Liang Xu, Liang Wang, Chun-Hui Cao, Shun-Liang Gao, Mohamed Adil Shah Khoodoruth, Bibi Zaina Ramjaun, Ting-Bo Liang, Department of Hepatobiliary-Pancreatic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Xue-Li
authors.initials: XL
authors.lastname: Bai
authors.forename: Yi-Wen
authors.initials: YW
authors.lastname: Chen
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Long-Yun
authors.initials: LY
authors.lastname: Ye
authors.forename: Yuan-Liang
authors.initials: YL
authors.lastname: Xu
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.forename: Chun-Hui
authors.initials: CH
authors.lastname: Cao
authors.forename: Shun-Liang
authors.initials: SL
authors.lastname: Gao
authors.forename: Mohamed Adil Shah
authors.initials: MA
authors.lastname: Khoodoruth
authors.forename: Bibi Zaina
authors.initials: BZ
authors.lastname: Ramjaun
authors.forename: Ai-Qiang
authors.initials: AQ
authors.lastname: Dong
authors.forename: Ting-Bo
authors.initials: TB
authors.lastname: Liang
mesh_terms: D000328:Adult; D006502:Budd-Chiari Syndrome / Q000209:etiology*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D007049:Iatrogenic Disease; D020347:Lithiasis / Q000601:surgery; D008107:Liver Diseases / Q000601:surgery; D008875:Middle Aged
keywords: Acute iatrogenic Budd-Chiari syndrome; Hepatectomy; Hepatolithiasis; Inferior vena cava
references.citation: N Engl J Med. 2004 Feb 5;350(6):578-85
references.pmid: 14762185
references.citation: Cardiovasc Intervent Radiol. 2010 Feb;33(1):205-8
references.pmid: 19629592
references.citation: J Am Coll Surg. 2012 Nov;215(5):622-6
references.pmid: 22921329
references.citation: Adv Anat Pathol. 2011 Jul;18(4):318-28
references.pmid: 21654363
references.citation: Am J Transplant. 2004 Jun;4(6):1006-9
references.pmid: 15147437
references.citation: World J Gastroenterol. 2007 May 21;13(19):2693-6
references.pmid: 17569137
references.citation: J Hepatol. 2004 Jan;40(1):172-80
references.pmid: 14672630
references.citation: Br J Surg. 2012 Oct;99(10):1423-8
references.pmid: 22961524
references.citation: Surg Oncol Clin N Am. 2002 Oct;11(4):849-64
references.pmid: 12607575
references.citation: Jpn Heart J. 2001 Jul;42(4):519-23
references.pmid: 11693287
references.citation: Ann Surg. 2010 Jan;251(1):84-90
references.pmid: 20032719
references.citation: J Hepatol. 2003 Mar;38(3):364-71
references.pmid: 12586305
references.citation: Nat Clin Pract Gastroenterol Hepatol. 2005 Apr;2(4):182-90
references.pmid: 16265183
references.citation: J Gastrointest Surg. 2010 May;14(5):910-2
references.pmid: 20112074