Portal vein thrombosis after devascularization operation and its prevention / 中华普通外科杂志

ABSTRACT

Objective To explore the pathogenesis,diagnosis,therapy and prevention of portal vein thrombosis (PVT) after devascularization.Methods Data of 56 patients who underwent devascularization because of cirrhotic portal hypertension between Jan.2008 and Dec.2011 were retrospectively analyzed.Patients were divided into two groups according to whether or not to receive prophylactic anticoagulant therapy.There were 28 cases in each group.The causes of PVT was analyzed by Logit regression.Results Among all patients,9 patients developed PVT after operation (16％).The occurrence of PVT was 11％ in preventive anticoagulant treatment group,and that was 21％ in nonpreventive anticoagulant treatment group.Logit regression showed that there was no relationship in PVT with sex,age,preoperative platelet count and intraoperative ligation of splenic artery beforehand.There were apparent correlation in PVT with centrifugal-flow of portal vein and peak value of platelet count over ≥300 ×109/L.All patients discharged uneventfully after anticoagulant treatment.Conclusions The definite cause of PVT after devascularization is centrifugal-flow of portal vein and the peak value of platelet count over ≥300 × 109/L is a pivotal risk factor.The key point of therapy is early diagnosis and early anticoagulant treatment.