Incidence, risk factors and outcomes for post-hepatectomy portal vein thrombosis: A retrospective study

doi:10.4240/wjgs.v17.i6.104729

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World Journal of Gastrointestinal Surgery

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Retrospective Study

World J Gastrointest Surg. Jun 27, 2025; 17(6): 104729
Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.104729

Incidence, risk factors and outcomes for post-hepatectomy portal vein thrombosis: A retrospective study

Jian-Ping Song, Ming Xiao, Ji-Ming Ma, Shang Zhang, Liu-Qing Yang, Zhi-Shuo Wang, Can-Hong Xiang

Jian-Ping Song, Ming Xiao, Department of Hepatobiliary Surgery, The Second Hospital of Shandong University, Jinan 250033, Shandong Province, China

Jian-Ping Song, Ming Xiao, Ji-Ming Ma, Shang Zhang, Can-Hong Xiang, Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China

Liu-Qing Yang, Department of Information Administration, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China

Zhi-Shuo Wang, Department of Hepatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining 810012, Qinghai Province, China

Author contributions: Song JP designed the study, collected the data, and wrote the first draft of the manuscript; Xiao M, Ma JM, Yang LQ offered statistical analysis; Zhang S, Wang ZS collected the data; Xiang CH revised the article, and the performed the research.

Institutional review board statement: This study was approved by the Research Ethics Board of Beijing Tsinghua Changgung Hospital (No. 23612-6-01).

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Data sharing statement: The data that support the findings of this study are available from the author, Song JP, upon reasonable request.

Corresponding author: Can-Hong Xiang, PhD, Doctor, Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing 102218, China. xcha01114@btch.edu.cn

Received: January 2, 2025
Revised: March 27, 2025
Accepted: May 9, 2025
Published online: June 27, 2025
Processing time: 151 Days and 9.4 Hours

Abstract

BACKGROUND

Post-hepatectomy portal vein thrombosis (PH-PVT) is a life-threatening complication; however, the available literature on this topic is limited.

AIM

To examine the incidence, risk factors, and outcomes associated with PH-PVT.

METHODS

Medical records of patients who underwent hepatic resection for various diseases between February 2014 and December 2023 at Beijing Tsinghua Changgung Hospital affiliated with Tsinghua University (Beijing, China) were retrospectively reviewed. The patients were divided into a PH-PVT group and a non-PH-PVT group. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for PH-PVT.

RESULTS

A total of 1064 patients were included in the study cohort, and the incidence and mortality rates of PH-PVT were 3.9% and 35.7%, respectively. The median time from hepatectomy to the diagnosis of PH-PVT was 6 days. Multivariate analysis revealed that hepatectomy combined with pancreaticoduodenectomy (HPD) [odds ratio (OR) = 7.627 (1.390-41.842), P = 0.019], portal vein reconstruction [OR = 6.119 (2.636-14.203), P < 0.001] and a postoperative portal vein angle < 100° [OR = 2.457 (1.131-5.348), P = 0.023] were independent risk factors for PH-PVT. Age ≥ 60 years [OR = 8.688 (1.774-42.539), P = 0.008] and portal vein reconstruction [OR = 6.182 (1.246-30.687), P = 0.026] were independent risk factors for mortality in PH-PVT patients.

CONCLUSION

Portal vein reconstruction, a postoperative portal vein angle < 100° and HPD were independent risk factors for PH-PVT. Age ≥ 60 years and portal vein reconstruction were independent risk factors for mortality in PH-PVT patients.

Keywords: Hepatectomy; Portal vein thrombosis; Incidence; Risk factors; Outcome; Retrospective study

Core Tip: This retrospective study included 1064 patients who underwent hepatectomy to investigate the incidence, risk factors, and outcomes associated with post-hepatectomy portal vein thrombosis (PH-PVT). This study meticulously examined the risk factors contributing to PH-PVT, with an aim of guiding clinicians in recognizing and preventing its occurrence. Furthermore, this study (for the first time) analyzed the mortality risk factors for PH-PVT to provide invaluable insights for the effective management of affected patients.