Predictive value of D-dimer for portal vein thrombosis after portal hypertension surgery in hepatitis B virus-related cirrhosis

doi:10.3748/wjg.v13.i48.6588

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Dec 28, 2007; 13(48): 6588-6592
Published online Dec 28, 2007. doi: 10.3748/wjg.v13.i48.6588

Predictive value of D-dimer for portal vein thrombosis after portal hypertension surgery in hepatitis B virus-related cirrhosis

Mei-Hai Deng, Bo Liu, He-Ping Fang, Wei-Dong Pan, Zhao-Feng Tang, Peng Deng, Yue-Si Zhong, Rui-Yun Xu

Mei-Hai Deng, Bo Liu, He-Ping Fang, Wei-Dong Pan, Zhao-Feng Tang, Peng Deng, Yue-Si Zhong, Rui-Yun Xu, Department of Hepato-biliary Surgery, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China

Supported by Technology Support Fund of Guangdong Province, No. 2004B35001007

Correspondence to: Dr. Mei-Hai Deng, Department of Hepato-biliary Surgery, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China. drdmh@medmail.com.cn

Telephone: +86-20-85613318 Fax: +86-20-85262937

Received: October 11, 2007
Revised: November 15, 2007
Accepted: November 26, 2007
Published online: December 28, 2007

Abstract

AIM: To evaluate the predictive value of D-dimer as a predictive indicator of portal vein thrombosis (PVT) after portal hypertension surgery in hepatitis B virus-related cirrhosis.

METHODS: A prospective study was carried out in 52 patients who had undergone surgery for portal hypertension in hepatitis B virus-related cirrhosis. Changes in perioperative dynamic D-dimer were observed. The sensitivity, specificity, positive predictive values and negative predictive values of D-dimer were calculated, and ROC curves were analyzed.

RESULTS: The D-dimer levels in the group developing postoperative PVT was significantly higher than those in the group not developing PVT (P = 0.001), and the ROC semi-quantitative and qualitative analysis of D-dimer showed a moderate predictive value in PVT (semi-quantitative value Az = 0.794, P = 0.000; qualitative analysis: Az = 0.739, P = 0.001).

CONCLUSION: Dynamic monitoring of D-dimer levels in patients with portal hypertension after surgery can help early diagnosis of PVT, as in cases where the D-dimer levels steadily increase and exceed 16 μg/mL, the possibility of PVT is very high.

Keywords: Portal hypertension, Portal vein thrombosis, Splenectomy, D-dimer, Diagnosis