Risk Factor Analysis of Portal Vein Thrombosis after Devascularization in Treatment of Patients with Cirrhotic Portal Hypertension_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 SHANGYu-qing , ZHUHong-lin

Department of General Surgery, Ya'an Hospital of Traditional Chinese Medicine, Ya'an 625000, Sichuan Province, China;

Corresponding?author：

SHANGYu-qing, Email: shangyuqing3@126.com

Keywords：

Portal vein thrombosis; Portal hypertension; Devascularization; Influence factor

DOI：

10.7507/1007-9424.20160375

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the risk factors of postoperative portal vein thrombosis (PVT) after devascu-larization in patients with cirrhotic portal hypertension. Methods The clinical data of 40 patients with cirrhotic portal hypertension treated with splenectomy and gastric pericardial devascularization were retrospectively analyzed to investigate the related risk factors. Results A total of 12 of the 40 patients suffered from PVT (30.00%). The results of multivariate analysis showed that portal vein diameter, postoperative portal vein velocity, platelet count at 2 weeks postoperatively, and postoperative portal vein pressure were the factors influencing the incidence of PVT after devascularization. Patients with the greater portal vein diameter and platelet count at 2 weeks postoperatively, the lower postoperative portal vein velocity and postoperative portal vein pressure, had higher ratio of PVT (P < 0.05). Conclusion Portal vein diameter, portal vein blood flow velocity, platelet count, and postoperative portal vein pressure were the main risk factors for PVT after surgery in patients with cirrhotic portal hypertension.

Citation： SHANGYu-qing, ZHUHong-lin. Risk Factor Analysis of Portal Vein Thrombosis after Devascularization in Treatment of Patients with Cirrhotic Portal Hypertension. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(12): 1488-1491. doi: 10.7507/1007-9424.20160375 Copy

1.	Mercado MA, Orozco H, Ramírez-Cisneros FJ, et al. Diminished morbidity and mortality in portal hypertension surgery:relocation in the therapeutic armamentarium. J Gastrointest Surg, 2001, 5(5):499-502.
2.	張軍, 鄧克學.能譜CT預測肝硬化門靜脈高壓患者并發食管靜脈曲張破裂出血風險.中國醫學影像技術, 2012, 28(12):2201-2205.
3.	Zong GQ, Fei Y, Chen J, et al. Selective double disconnection for cirrhotic portal hypertension. J Surg Res, 2014, 192(2):383-389.
4.	Bureau C, Thabut D, Oberti F, et al. Transjugular intrahepatic porto-systemic shunts with covered stents increase transplant-free survival of patients with cirrhosis and recurrent ascites. Gastroenterology, 2016, [Epub ahead of print].
5.	Zocco MA, Di Stasio E, De Cristofaro R, et al. Thrombotic risk factors in patients with liver cirrhosis:correlation with MELD scoring system and portal vein thrombosis development. J Hepatol, 2009, 51(4):682-689.
6.	李倉, 張啟瑜, 孫克龍, 等.肝癌切除聯合選擇性減斷流術在原發性肝癌合并中重度門靜脈高壓癥中的應用.肝膽胰外科雜志, 2015, 27(1):5-8.
7.	葉劍橋.手術治療肝硬化門靜脈高壓癥并發上消化道出血臨床療效分析.檢驗醫學與臨床, 2014, 11(4):514-515.
8.	余靈祥, 張紹庚, 郭曉東, 等.門靜脈高壓癥脾切斷流術后血栓形成的臨床研究.現代生物醫學進展, 2014, 14(20):3857-3859.
9.	Sun L, Zhou H, Gu L, et al. Effects of surgical procedures on the occurrence and development of postoperative portal vein thrombosis in patients with cirrhosis complicated by portal hypertension. Int J Surg, 2015, 16(Pt A):31-35.
10.	王茂春, 李澍, 朱繼業, 等.門靜脈高壓癥外科手術后門靜脈系統血栓形成的原因及防治.中國鄉村醫藥, 2004, 11(9):269-271.
11.	王東, 栗光明, 朱繼業, 等.保脾斷流術治療門靜脈高壓癥上消化道出血的療效分析.中國普外基礎與臨床雜志, 2013, 20(1):29-32.
12.	Marcus R, Peter H. Management of portal hypertension, Budd-Chiari syndrome and portal vein thrombosis. Medicine, 2015, 43(11):669-673.
13.	陳煒, 吳志勇.肝硬變門靜脈高壓癥外科干預的時機和術式選擇.中國普外基礎與臨床雜志, 2015, 22(11):1296-1299.
14.	Makdissi FF, Herman P, Machado MA, et al. Portal vein thrombosis after esophagogastric devascularization and splenectomy in schisto-somal portal hypertension patients:what's the real importance? Arq Gastroenterol, 2009, 46(1):50-56.
15.	楊健, 鐘麟.低分子肝素鈣在脾切斷流術后預防門靜脈血栓形成的臨床觀察.中國藥房, 2012, 23(24):2254-2257.
16.	楊科, 楊啟.肝癌切除聯合斷流術治療原發性肝癌合并門靜脈高壓癥的療效.世界華人消化雜志, 2014, 22(19):2780-2783.
17.	李鐵漢, 唐波, 唐繼紅, 等.脾切除術后門靜脈系血栓形成的臨床診治.中國普通外科雜志, 2010, 19(12):1324-1326.
18.	肖華鑫, 王敏, 李健, 等.普萘洛爾聯合5-單硝酸異山梨酯對肝硬化門靜脈高壓血流動力學參數的影響.中國病原生物學雜志, 2012, 7(3):220-221, 227.
19.	Yong Y, Ma JL, Yu JH. Multivariate analysis of portal vein thrombosis formation after devascularization in patients with portal hypertension. J Hepatobil Surg, 2014, 43(5):356-359.
20.	劉思達, 黎一鳴, 吉鴻, 等.賁門周圍血管離斷術治療門靜脈高壓癥療效的Meta分析.中國普外基礎與臨床雜志, 2014, 21(1):69-75.
21.	吳曉峰, 伏志, 劉召波, 等.肝硬化門靜脈高壓患者行脾切除斷流術后早期門靜脈血栓形成的原因分析.臨床肝膽病雜志, 2015, 31(3):400-403.
22.	包漢康, 韋秀麗.手助腹腔鏡脾切除賁門周圍血管離斷術對肝硬化門靜脈高壓的療效分析.臨床肝膽病雜志, 2015, 31(3):431-433.
23.	Sun YW, Luo M, Chen W, et al. Portal vein thrombosis formation in patients submitted to portal hypertension operation. J Surg Concepts Pract, 2006, 92(6):108.
24.	羅鳳球, 鄧維成, 丁國建, 等.腹腔鏡與開腹脾切除賁門周圍血管離斷術治療門靜脈高壓癥的Meta分析.中國普通外科雜志, 2013, 22(9):1195-1201.
25.	謝亮, 王姝, 蔣勇, 等.斷流術聯合腸腔分流術治療肝硬變斷流術后再出血23例報道.中國普外基礎與臨床雜志, 2015, 22(11):1366-1367.
26.	Kinjo N, Kawanaka H, Akahoshi T, et al. Risk factors for portal venous thrombosis after splenectomy in patients with cirrhosis and portal hypertension. Br J Surg, 2010, 97(6):910-916.

1. Mercado MA, Orozco H, Ramírez-Cisneros FJ, et al. Diminished morbidity and mortality in portal hypertension surgery:relocation in the therapeutic armamentarium. J Gastrointest Surg, 2001, 5(5):499-502.
2. 張軍, 鄧克學.能譜CT預測肝硬化門靜脈高壓患者并發食管靜脈曲張破裂出血風險.中國醫學影像技術, 2012, 28(12):2201-2205.
3. Zong GQ, Fei Y, Chen J, et al. Selective double disconnection for cirrhotic portal hypertension. J Surg Res, 2014, 192(2):383-389.
4. Bureau C, Thabut D, Oberti F, et al. Transjugular intrahepatic porto-systemic shunts with covered stents increase transplant-free survival of patients with cirrhosis and recurrent ascites. Gastroenterology, 2016, [Epub ahead of print].
5. Zocco MA, Di Stasio E, De Cristofaro R, et al. Thrombotic risk factors in patients with liver cirrhosis:correlation with MELD scoring system and portal vein thrombosis development. J Hepatol, 2009, 51(4):682-689.
6. 李倉, 張啟瑜, 孫克龍, 等.肝癌切除聯合選擇性減斷流術在原發性肝癌合并中重度門靜脈高壓癥中的應用.肝膽胰外科雜志, 2015, 27(1):5-8.
7. 葉劍橋.手術治療肝硬化門靜脈高壓癥并發上消化道出血臨床療效分析.檢驗醫學與臨床, 2014, 11(4):514-515.
8. 余靈祥, 張紹庚, 郭曉東, 等.門靜脈高壓癥脾切斷流術后血栓形成的臨床研究.現代生物醫學進展, 2014, 14(20):3857-3859.
9. Sun L, Zhou H, Gu L, et al. Effects of surgical procedures on the occurrence and development of postoperative portal vein thrombosis in patients with cirrhosis complicated by portal hypertension. Int J Surg, 2015, 16(Pt A):31-35.
10. 王茂春, 李澍, 朱繼業, 等.門靜脈高壓癥外科手術后門靜脈系統血栓形成的原因及防治.中國鄉村醫藥, 2004, 11(9):269-271.
11. 王東, 栗光明, 朱繼業, 等.保脾斷流術治療門靜脈高壓癥上消化道出血的療效分析.中國普外基礎與臨床雜志, 2013, 20(1):29-32.
12. Marcus R, Peter H. Management of portal hypertension, Budd-Chiari syndrome and portal vein thrombosis. Medicine, 2015, 43(11):669-673.
13. 陳煒, 吳志勇.肝硬變門靜脈高壓癥外科干預的時機和術式選擇.中國普外基礎與臨床雜志, 2015, 22(11):1296-1299.
14. Makdissi FF, Herman P, Machado MA, et al. Portal vein thrombosis after esophagogastric devascularization and splenectomy in schisto-somal portal hypertension patients:what's the real importance? Arq Gastroenterol, 2009, 46(1):50-56.
15. 楊健, 鐘麟.低分子肝素鈣在脾切斷流術后預防門靜脈血栓形成的臨床觀察.中國藥房, 2012, 23(24):2254-2257.
16. 楊科, 楊啟.肝癌切除聯合斷流術治療原發性肝癌合并門靜脈高壓癥的療效.世界華人消化雜志, 2014, 22(19):2780-2783.
17. 李鐵漢, 唐波, 唐繼紅, 等.脾切除術后門靜脈系血栓形成的臨床診治.中國普通外科雜志, 2010, 19(12):1324-1326.
18. 肖華鑫, 王敏, 李健, 等.普萘洛爾聯合5-單硝酸異山梨酯對肝硬化門靜脈高壓血流動力學參數的影響.中國病原生物學雜志, 2012, 7(3):220-221, 227.
19. Yong Y, Ma JL, Yu JH. Multivariate analysis of portal vein thrombosis formation after devascularization in patients with portal hypertension. J Hepatobil Surg, 2014, 43(5):356-359.
20. 劉思達, 黎一鳴, 吉鴻, 等.賁門周圍血管離斷術治療門靜脈高壓癥療效的Meta分析.中國普外基礎與臨床雜志, 2014, 21(1):69-75.
21. 吳曉峰, 伏志, 劉召波, 等.肝硬化門靜脈高壓患者行脾切除斷流術后早期門靜脈血栓形成的原因分析.臨床肝膽病雜志, 2015, 31(3):400-403.
22. 包漢康, 韋秀麗.手助腹腔鏡脾切除賁門周圍血管離斷術對肝硬化門靜脈高壓的療效分析.臨床肝膽病雜志, 2015, 31(3):431-433.
23. Sun YW, Luo M, Chen W, et al. Portal vein thrombosis formation in patients submitted to portal hypertension operation. J Surg Concepts Pract, 2006, 92(6):108.
24. 羅鳳球, 鄧維成, 丁國建, 等.腹腔鏡與開腹脾切除賁門周圍血管離斷術治療門靜脈高壓癥的Meta分析.中國普通外科雜志, 2013, 22(9):1195-1201.
25. 謝亮, 王姝, 蔣勇, 等.斷流術聯合腸腔分流術治療肝硬變斷流術后再出血23例報道.中國普外基礎與臨床雜志, 2015, 22(11):1366-1367.
26. Kinjo N, Kawanaka H, Akahoshi T, et al. Risk factors for portal venous thrombosis after splenectomy in patients with cirrhosis and portal hypertension. Br J Surg, 2010, 97(6):910-916.

Previous Article
Feasibility Discussion of Delta-Shaped Gastroduodenostomy During Totally Laparoscopic Distal Gastrectomy in Treatment of Gastric Cancer
Next Article
Analysis of Influence Factors of Gallstone

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Risk Factor Analysis of Portal Vein Thrombosis after Devascularization in Treatment of Patients with Cirrhotic Portal Hypertension

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content