Application of eversion embolectomy for portal vein thrombosis on liver transplantation / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To discuss the technical improvement of the conventional thrombectomy for portal vein thrombosis (PVT) on liver transplantation.</p><p><b>METHODS</b>The clinical data of 198 cases of liver transplantation with PVT who admitted in Tianjin First Central Hospital were analyzed retrospectively. According to the different treatments for PVT, these cases were divided into group A and group B. The conventional eversion embolectomy were performed in group A (n = 43) and the improved eversion embolectomy were performed in group B (n = 155). The general conditions, blood loss volumes, the achievement ratio of embolectomy, PVT recurrence rate and survival rate between the two groups were compared.</p><p><b>RESULTS</b>No statistical significance on operation time between two groups (P > 0.05); the achievement ratio of embolectomy for Yerdel I-II were 100% in two groups, however, the achievement ratio of embolectomy for Yerdel III in group B was higher than that of group A (100% vs. 45.45%; chi(2) = 12.38, P < 0.01). Blood loss volumes in group B was significantly lower than that of group A [(4315.4 +/- 630.5) ml vs. (3509.2 +/- 862.7) ml, P < 0.05]. No statistical significance on Yerdel I and II PVT recurrence rate between two groups (P > 0.05). While thrombosis recurrent rate of Yerdel III PVT in group B was lower than that of group A(5.6% vs. 2/5; chi(2) = 4.09, P < 0.05). Perioperative mortality of Yerdel I-III patients were both 0 in two groups. 1-year survival rate of Yerdel I-III patients was similar in two groups (86.5% vs. 89.0%, P > 0.05).</p><p><b>CONCLUSIONS</b>Improved eversion embolectomy can simplify the operation procedures, reduce blood loss, expand application range, increase the embolectomy success rate, decrease the PVT relapse rate.</p>