title: Incidence, risk factors, and management options for portal vein thrombosis after hepatectomy: a 14-year, single-center experience.
abstract: BACKGROUND
  Portal vein thrombosis (PVT) after hepatectomy is rare; however, it increases mortality and morbidity. Few studies have been conducted that focused on PVT following major hepatectomy.
  
  
  METHODS
  Patients who underwent hepatectomy at a single institution were retrospectively reviewed, and risk factors and management options were evaluated.
  
  
  RESULTS
  Of the 1,193 patients undergoing hepatectomy, 25 patients developed PVT. Right-sided hepatectomy, caudate lobectomy, splenectomy, and postoperative bile leakage were independent risk factors for PVT following hepatectomy. PVT occurred more frequently after major hepatectomy compared with minor hepatectomy. Increased instability and reduced portal venous flow caused by kinking was the reason for increasing the risk of PVT after right-sided hepatectomy with caudate lobectomy. The new operative procedure, suturing the posterior wall of the portal vein with the anterior wall of the inferior vena cava, was effective for reducing the risk of PVT following right-sided hepatectomy. Operative thrombectomy showed significant benefits for PVT detected within 5 days after hepatectomy.
  
  
  CONCLUSIONS
  PVT frequently occurs following major hepatectomy. Urgent operative thrombectomy is strongly recommended for PVT with early detection.
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
authors: Satoshi
authors: S
authors: Kuboki
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
authors: Hiroaki
authors: H
authors: Shimizu
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
authors: Masayuki
authors: M
authors: Ohtsuka
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
authors: Atsushi
authors: A
authors: Kato
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
authors: Hideyuki
authors: H
authors: Yoshitomi
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
authors: Katsunori
authors: K
authors: Furukawa
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
authors: Tsukasa
authors: T
authors: Takayashiki
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
authors: Shigetsugu
authors: S
authors: Takano
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
authors: Daiki
authors: D
authors: Okamura
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
authors: Daisuke
authors: D
authors: Suzuki
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
authors: Nozomu
authors: N
authors: Sakai
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
authors: Shingo
authors: S
authors: Kagawa
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan. Electronic address: masaru@faculty.chiba-u.jp.
authors: Masaru
authors: M
authors: Miyazaki
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000925:Anticoagulants / Q000627:therapeutic use; D001646:Bile; D005260:Female; D005334:Fever / Q000209:etiology; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D022124:Hyperammonemia / Q000209:etiology; D015994:Incidence; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology; D011169:Portal Vein / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013156:Splenectomy / Q000009:adverse effects; D017131:Thrombectomy; D014682:Vena Cava, Inferior / Q000601:surgery; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*
chemical_list: D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D005340:Fibrinogen
keywords: Caudate lobectomy; Major hepatectomy; Operative thrombectomy; Portal vein thrombosis; Right-sided hepatectomy