Buc E, Dokmak S, Zappa M, Denninger MH, Valla DC, Belghiti J, Farges O. Hepatic veins as a site of clot formation following liver resection. World J Gastroenterol 2011; 17(3): 403-406 [PMID: 21253403 DOI: 10.3748/wjg.v17.i3.403]
Corresponding Author of This Article
Olivier Farges, MD, PhD, Professor, Department of Hepato-Biliary Surgery, Hôpital Beaujon, Assistance-Publique Hôpitaux de Paris, University Paris 7, 100 boulevard du General Leclerc, 92118 Clichy, France. olivier.farges@bjn.aphp.fr
Article-Type of This Article
Case Report
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World J Gastroenterol. Jan 21, 2011; 17(3): 403-406 Published online Jan 21, 2011. doi: 10.3748/wjg.v17.i3.403
Hepatic veins as a site of clot formation following liver resection
Emmanuel Buc, Safi Dokmak, Magaly Zappa, Marie Helene Denninger, Dominique Charles Valla, Jacques Belghiti, Olivier Farges
Emmanuel Buc, Safi Dokmak, Jacques Belghiti, Olivier Farges, Department of Hepato-Biliary Surgery, Hôpital Beaujon, Assistance-Publique Hôpitaux de Paris, University Paris 7, 92118 Clichy, France
Magaly Zappa, Department of Radiology, Hôpital Beaujon, Assistance-Publique Hôpitaux de Paris, University Paris 7, 92118 Clichy, France
Marie Helene Denninger, Department of Biological Hematology, Hôpital Beaujon, Assistance-Publique Hôpitaux de Paris, University Paris 7, 92118 Clichy, France
Dominique Charles Valla, Department of Hepatology, Hôpital Beaujon, Assistance-Publique Hôpitaux de Paris, University Paris 7, 92118 Clichy, France
Author contributions: Buc E and Farges O produced the concept, designed the study, and drafted the manuscript; Buc E and Dokmak S were responsible for acquisition of data; Buc E, Zappa M and Farges O analysed and interpreted data; Valla DC, Belghiti J and Denninger MH revised the manuscript for important intellectual content; Farges O supervised the study.
Correspondence to: Olivier Farges, MD, PhD, Professor, Department of Hepato-Biliary Surgery, Hôpital Beaujon, Assistance-Publique Hôpitaux de Paris, University Paris 7, 100 boulevard du General Leclerc, 92118 Clichy, France. olivier.farges@bjn.aphp.fr
Telephone: +33-1-40875222 Fax: +33-1-40870926
Received: July 29, 2010 Revised: September 6, 2010 Accepted: September 13, 2010 Published online: January 21, 2011
Abstract
Pulmonary embolism occurs more frequently after hepatectomy than previously thought but is infrequently associated with peripheral deep vein thrombosis. In this paper, we report 2 cases of postoperative hepatic vein thrombosis after liver resection. Both patients had undergone major hepatectomy of a non-cirrhotic liver largely exposing the middle hepatic vein. Clots were incidentally found in the middle hepatic vein 4 and 17 d after surgery despite routine systemic thrombo-prophylaxis with low molecular weight heparin. Coagulation of the transition plan in a context of mutation of the prothrombin gene and inflammation induced biloma were the likely predisposing conditions. Clots disappeared following curative anticoagulation. We conclude that thrombosis of hepatic veins may occur after liver resection and is a potential source of pulmonary embolism.
