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4 . 2020

Portal vein thrombosis after anatomical liver resection: case report

Abstract

Background. Portal vein thrombosis is a polyetiological life-threatening complication of various thrombophilic conditions. According to some reports, after a liver resection, the frequency of this complication is 3.6-9.1%. Up to a quarter (21-24%) of all cases of portal vein thrombosis, it is associated with malignant neoplasms of the abdominal organs. Polyetiology of this complication, particularly in patients after surgical procedures, defines a variety of possible clinical situations of undoubted clinical interest.

The aim of this work is to present a clinical case of postoperative thrombosis of the portal vein (Grade IV by Yerdel) with effective treatment due to etiotropic therapy.

Material and methods. A 68 years woman with intrahepatic cholangiocarcinoma 6 days after the right-hemihepatectomy performed without the Pringle-maneuver, developed portal vein trunk thrombosis.

Results. The patient had a whole range of possible etiological factors of thrombosis. Despite its massive character (Grade IV on Yerdel), carrying out etiotropic therapy led to the patient's recovery. 
Conclusion. Identification of all risk factors for thrombosis, in particular anamnestic data on the possible presence of antiphospholipid syndrome, should determine the change in the volume of preoperative examination and preoperative preparation. Etiotropic treatment determines its effectiveness even with massive thrombosis.

Keywords:portal vein thrombosis, liver resection, postoperative thrombosis, antiphospholipid syndrome

Funding. The study had no sponsor support.
Conflict of interests. The authors declare no conflict of interests.
Contribution. Article writing, analysis of literature and preparation of descriptive and analytical parts of the work - Semenkov A.V.; preparation of the initial project, data collection, clinical management - Bachewskaya V.A.; conceptualization, viewing and editing - Sorokina L.S.; preparation and presentation of the illustrative part of the work - Yurichenko Yu.Yu.; preparation of a descriptive part on instrumental examination methods - Shchekoturov I.O.
For citation: Semenkov A.V., Bachewskaya V.A., Sorokina L.S., Yurichenko Yu.Yu., Shchekoturov I.O. Portal vein thrombosis after anatomical liver resection. Case report. Clinical and Experimental Surgery. Petrovsky Journal. 2020; 8 (4): 154-60. DOI: https://doi.org/10.33029/2308-1198-2020-8-4-154-160 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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