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d-dimer-based screening for early diagnosis of venous thromboembolism after hepatectomy

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Abstract

Purpose

The aim of this study was to evaluate the clinical utility of a novel diagnostic algorithm based on serum d-dimer levels for venous thromboembolism (VTE) after hepatectomy.

Methods

We retrospectively analyzed 742 consecutive patients who underwent hepatectomy in our hospital from 2009 to 2019. From 2015, we routinely measured serum d-dimer level postoperatively and computed tomography was performed when d-dimer level was ≥ 20 μg/mL.

Results

VTE was diagnosed in 26 patients and pulmonary embolism (PE) was diagnosed in 18 patients. Multivariate analysis revealed that resected liver weight ≥ 120 g is a significant predictor of VTE (P = 0.011). The incidence of VTE from 2015 to 2019 was greater than that from 2009 to 2014 (5.0% versus 2.1%, P = 0.044). The number of low-risk PE patients between 2015 and 2019 was significantly greater than that between 2009 and 2014 (P = 0.013). There was no in-hospital mortality of patients with PE from 2015 to 2019.

Conclusion

Patients who undergo hepatectomy are at high risk for VTE, especially when the resected liver weight is high. The proposed diagnostic algorithm based on serum d-dimer levels for VTE after hepatectomy can be useful for early diagnosis.

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Data availability

The dataset analyzed for the current study are available from the corresponding author on reasonable request.

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Acknowledgments

The authors would like to thank Enago (www.enago.com) for the English language review.

Author information

Authors and Affiliations

  1. Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan

    Shinji Onda, Kenei Furukawa, Koichiro Haruki, Ryoga Hamura, Yoshihiro Shirai, Jungo Yasuda, Hironori Shiozaki, Takeshi Gocho, Hiroaki Shiba & Toru Ikegami

Authors
  1. Shinji Onda
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  2. Kenei Furukawa
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  3. Koichiro Haruki
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  4. Ryoga Hamura
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  5. Yoshihiro Shirai
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  6. Jungo Yasuda
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  7. Hironori Shiozaki
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  8. Takeshi Gocho
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  9. Hiroaki Shiba
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  10. Toru Ikegami
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Contributions

Study conception and design: Onda S. Acquisition of data: Onda S, Furukawa K, Haruki K, Shirai Y, Hamura R, Yasuda J, Shiozaki H, Gocho T, and Shiba H. Analysis and interpretation of data: Furukawa K, Haruki K, and Shirai Y. Drafting of manuscript: Onda S. Critical revision of manuscript: Ikegami T

Corresponding author

Correspondence to Shinji Onda.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

The study meeting the ethical standards of the World Medical Association Declaration of Helsinki and its protocol was approved by the ethics committee of the Jikei University School of Medicine (27-177[8062]).

Consent to participate

Written informed consent was obtained from each patient.

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The participant has consented to the submission of the case report to the journal.

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Onda, S., Furukawa, K., Haruki, K. et al. d-dimer-based screening for early diagnosis of venous thromboembolism after hepatectomy. Langenbecks Arch Surg 406, 883–892 (2021). https://doi.org/10.1007/s00423-020-02058-9

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  • DOI: https://doi.org/10.1007/s00423-020-02058-9

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