Portal Vein Thrombosis after Major Liver Resection for Cholangiocarcinoma and Gallbladder Cancer

Abstract

Introduction: The incidence of and risk factors for postoperative portal vein thrombosis after major liver resection with resection of extrahepatic bile ducts for gallbladder cancer and intrahepatic cholangiocarcinoma with hilar extension, and perihilar cholangiocarcinoma have not been fully elucidated. Method: In this retrospective cohort study, we analysed the influence of clinical, procedural and pathological factors with respect to the incidence of postoperative portal vein thrombosis. Results: A total of 99 patients were included, of whom 9 patients developed portal vein thrombosis diagnosed 6 (1-18) days after operation. Treatment consisted of thrombectomy and anticoagulation only in 3 and 6 patients, respectively. In patients receiving anticoagulation only, the portal thrombosis was partial in 3 patients. Recanalisation was achieved in all patients. No specific factor was found predictive of portal vein thrombosis, including age (p=0.188), type of cancer (p=0.126), type of liver resection (p=0.871), caudate lobe resection (p=0.493) or portal vein resection (p=0.235). Conclusions: Portal vein thrombosis is a common complication after major liver resection for biliary cancers. Anticoagulation or reoperation with thrombectomy are both effective treatments.