Diagnosis and Treatment for Patients with Portal Vein Thrombosis or Tumor Embolus in Perioperative Period of Liver Transplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Kunming Medical College, Kunming 650101, China;

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Keywords：

Liver transplantation; Portal vein thrombosis; Portal vein tumor embolus

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Objective 　To explore the diagnosis and treatment for patients with portal vein thrombosis or tumor embolus in perioperative period of liver transplantation.
Methods 　Eight patients at terminal stage of liver diseases and with portal vein thrombosis or tumor embolus underwent liver transplantation in this hospitatal from October 1999 to January 2006. Their clinical information and survival situation were retrospectively analyzed.
Results 　 It was diagnosed correctly before operations that portal vein thrombosis or tumor embolus occurred in 8 patients of 61 patients (13.1%) who underwent liver transplantation (grade Ⅰ: 3 cases; grade Ⅱ: 5 cases). The thrombosis in the portal vein of 6 cases were dislodged and the portal vein with tumor embolus were removed in 2 patients who underwent end-to-end anastomosis. All patients received anticogulation therapy after operations. The post-operative 6-month survival rate was 62.5%.
Conclusion 　Accurate diagnosis before operation, correct method of surgery and reasonable management after operation may have significant effects on the patients with portal vein thrombosis or tumor embolus.

Citation： WEI Xiaoping,LI Li,RAN Jianghua,TIAN Daguang,DIAO Chang,ZHANG Shengning. Diagnosis and Treatment for Patients with Portal Vein Thrombosis or Tumor Embolus in Perioperative Period of Liver Transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2007, 14(4): 459-462. doi: Copy

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1. 　Molmenti EP, Roodhouse TW, Molmenti H, et al. Thrombendvenectomy for organized portal vein thrombosis at the time of liver transplantation [Ｊ]. Ann Surg, 2002; 235(2)∶292.
2. 　朱志军, 蔡金珠, 孟醒初, 等.肝移植中合并门静脉血栓的诊断和处理 [Ｊ]. 中华肝胆外科杂志, 2004; 10(7)∶473.
3. 　Amitrano L, Guardascione MA, Brancaccio V, et al. Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis [Ｊ]. J Hepatol, 2004; 40(5)∶736.
4. 　Yerdel MA, Gunson B, Mirza D, et al. Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome [Ｊ]. Transplantation, 2000; 69(9)∶1873.
5. 　Mitraite D, Krimelis A. The possibility of the investigation of portal vein thrombosis by means of ultrasonography [Ｊ]. Medicina (Kaunas), 2002; 38(2)∶205.
6. 　吴凤东, 任秀昀, 陈新国, 等. 肝脏移植中门静脉机化血栓的诊断 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(2)∶147.
7. 　Tanaka K, Numata K, Okazaki H, et al. Diagnosis of portal vein thrombosis in patients with hepatocellular carcinoma: efficacy of color Doppler sonography compared with angiography [Ｊ]. AJR Am J Roentgenol, 1993; 160(6)∶1279.
8. 　Robles R, Fernandez JA, Hernandez Q, et al. Eversion thromboendovenectomy in organized portal vein thrombosis during liver transplantation [Ｊ]. Clin Transplant, 2004; 18(1)∶79.
9. 　严佶祺, 彭承宏, 李宏为. 肝移植中门静脉血栓的外科处理 [Ｊ]. 中华普通外科杂志, 2005; 20(8)∶538.
10. 　Pinna AD, Nery J, Kato T, et al. Liver transplant with portocaval hemitransposition: experience at the University of Miami [Ｊ]. Transplant Proc, 2001; 33(1-2)∶1329.
11. 　李磊, 张同琳, 宋世兵, 等. 存在门静脉血栓及癌栓的肝癌患者的肝移植 [Ｊ]. 中华器官移植杂志, 2005; 26(3)∶136.
12. 　李汛, 李玉民, 石斌, 等. 肝移植术后肝动脉血栓的防治（附2例报告） [Ｊ]. 中国普外基础与临床杂志, 2005; 12(5)　∶511.
13. 　严律南, 王震侠. 肝癌肝移植的适用症及应用前景 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(2)∶132.
14. 　Yang TS, Wang CH, Hsieh RK, et al. Gemcitabine and doxorubicin for the treatment of patients with advanced hepatocellular carcinoma: a phase Ⅰ-Ⅱ trial [Ｊ]. Ann Oncol, 2002; 13(11)∶1771.
15. 　郑树森, 徐骁, 俞军, 等. 肝移植治疗治疗肝细胞癌合并门静脉癌栓的临床价值 [Ｊ]. 中国实用外科杂志, 2004; 24(9)∶540　.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Treatment for Patients with Portal Vein Thrombosis or Tumor Embolus in Perioperative Period of Liver Transplantation

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