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Prediction of portal vein thrombosis after hepatectomy for hepatocellular carcinoma

  • Original Article
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Abstract

Purpose

Portal vein thrombosis (PVT) following hepatectomy is potentially life-threatening. We aimed to evaluate the incidence of PVT after hepatectomy for hepatocellular carcinoma and identify coagulation and fibrinolytic factors that could predict early-stage postoperative PVT.

Methods

A retrospective analysis was conducted on 65 hepatocellular carcinoma patients who underwent radical hepatectomy. The risk factors for postoperative PVT were identified based on univariate and multivariate analyses, and the levels of coagulation and fibrinolytic factors were measured during the perioperative period.

Results

The incidence of PVT after hepatectomy was 20.0%. The patients were divided into two groups: those with PVT (n=13; PVT group) and those without PVT (n=52; no-PVT group). The frequency of the use of the Pringle maneuver during surgery was higher in the PVT group than in the no-PVT group, and the postoperative/preoperative ratios of thrombin-antithrombin III complex (TAT) and of D-dimer were significantly higher in the PVT group.

Conclusion

A high incidence of PVT was found in hepatocellular carcinoma patients after hepatectomy. The frequency of the Pringle maneuver is a potential risk factor for postoperative PVT, and the postoperative/preoperative TAT and D-dimer ratios may be used as early predictors of PVT after hepatectomy for hepatocellular carcinoma.

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Data Availability

Data is available on request from the corresponding author.

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Acknowledgements

We would like to thank Editage (http://www.editage.jp) for English language editing.

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Authors and Affiliations

  1. Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan

    Hideyuki Takata, Atsushi Hirakata, Junji Ueda, Tadashi Yokoyama, Hiroshi Maruyama, Ryotaro Takano, Takahiro Haruna & Hiroshi Makino

  2. Department of Gastrointestinal Surgery, Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan

    Junji Ueda & Nobuhiko Taniai

  3. Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan

    Hiroshi Yoshida

Authors
  1. Hideyuki Takata
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  2. Atsushi Hirakata
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Contributions

Study conception and design: Hideyuki Takata, Atsushi Hirakata, Junji Ueda, and Hiroshi Yoshida. Acquisition of data: Hideyuki Takata, Atsushi Hirakata, Junji Ueda, Tadashi Yokoyama, Hiroshi Maruyama, Nobuhiko Taniai, Ryotaro Takano, and Takahiro Haruna. Analysis and interpretation of data: Hideyuki Takata, Atsushi Hirakata, Junji Ueda, and Hiroshi Makino. Drafting of manuscript: Hideyuki Takata. Critical revision of manuscript: Hiroshi Yoshida.

Corresponding author

Correspondence to Hideyuki Takata.

Ethics declarations

Ethics approval

This study was carried out under the principles embodied in the Declaration of Helsinki, 2013, and was approved by the institutional review board of the Nippon Medical School Tama Nagayama Hospital (Approval number: 627).

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Informed consent was obtained from all individual patients included in the study.

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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Supplementary information

Supplementary Fig. 1

Time-course changes of the ratio of the postoperative to the preoperative values of coagulation and fibrinolytic factors. (a) PIC. (b) Total PAI-1. (c) platelet count. (d) PT activity. (e) APTT. (f) AT-III activity. (PNG 977 kb)

High Resolution Image (TIF 183 kb)

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Takata, H., Hirakata, A., Ueda, J. et al. Prediction of portal vein thrombosis after hepatectomy for hepatocellular carcinoma. Langenbecks Arch Surg 406, 781–789 (2021). https://doi.org/10.1007/s00423-021-02125-9

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  • DOI: https://doi.org/10.1007/s00423-021-02125-9

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