Prediction of Portal Vein Thrombosis Following Hepatectomy for Perihilar Cholangiocarcinoma: Efficacy of Postoperative Portal Vein Diameter Ratio and Angle
Prediction of Portal Vein Thrombosis Following Hepatectomy for Perihilar Cholangiocarcinoma: Efficacy of Postoperative Portal Vein Diameter Ratio and Angle
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DOI：
10.21873/anticanres.13692
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发表时间：
2019-09-01
影响因子：
2
通讯作者：
Uesaka, Katsuhiko
中科院分区：
文献类型：
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作者：
Uchida, Tsuneyuki;Yamamoto, Yusuke;Uesaka, Katsuhiko
背景：门静脉血栓形成（PVT）是肝切除术后危及生命的并发症。然而，术后肺静脉血栓形成和肺静脉形态特征之间的关系尚未完全阐明。患者和方法：共81例肝门周胆管癌（PHCC）行肝切除术的患者进行了研究。我们使用SYNAPSE VINCENT（R）重建的术前和术后计算机断层扫描（CT）研究了肺静脉的直径和角度。结果：肝切除术后门静脉血栓形成的发生率为11.1%。在残肝PV直径方面存在显著差异（p=0.015），直径比（p=0.001），术后肺静脉角（p=0.001）。多变量分析显示，术后肺静脉角小于90度结论：术后门静脉角度小于90 °、直径比小于45%是PHCC术后发生门静脉血栓的独立危险因素。
Background: Portal vein thrombosis (PVT) is a life-threatening complication after hepatectomy. However, the relationship between postoperative PVT and morphometric features of the PV has not been fully elucidated yet. Patients and Methods: A total of 81 patients who underwent hepatectomy for perihilar cholangio-carcinoma (PHCC) were studied. We investigated the diameters and angles of PV using pre- and postoperative computed tomography (CT) reconstructed by SYNAPSE VINCENT (R). Results: The incidence of PVT after hepatectomy was 11.1%. There were significant differences with respect to the remnant liver PV diameter (p=0.015), the diameter ratio (p=0.001), and the postoperative PV angle (p=0.001) between patients with and without PVT. Multivariate analysis revealed that a postoperative PV angle of less than 90 degrees (p=0.008) and a diameter ratio of less than 45% (p=0.041) were independent risk factors for PVT. Conclusion: A postoperative PV angle of less than 90 degrees and diameter ratio of less than 45% eventually lead to PVT after hepatectomy for PHCC.