Case Report
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World J Gastroenterol. Sep 14, 2013; 19(34): 5763-5768
Published online Sep 14, 2013. doi: 10.3748/wjg.v19.i34.5763
Acute iatrogenic Budd-Chiari syndrome following hepatectomy for hepatolithiasis: A report of two cases
Xue-Li Bai, Yi-Wen Chen, Qi Zhang, Long-Yun Ye, Yuan-Liang Xu, Liang Wang, Chun-Hui Cao, Shun-Liang Gao, Mohamed Adil Shah Khoodoruth, Bibi Zaina Ramjaun, Ai-Qiang Dong, Ting-Bo Liang
Xue-Li Bai, Yi-Wen Chen, Qi Zhang, Long-Yun Ye, Yuan-Liang Xu, Liang Wang, Chun-Hui Cao, Shun-Liang Gao, Mohamed Adil Shah Khoodoruth, Bibi Zaina Ramjaun, Ting-Bo Liang, Department of Hepatobiliary-Pancreatic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
Ai-Qiang Dong, Department of Cardiothoracic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
Author contributions: Liang TB designed the study; Bai XL, Chen YW, Zhang Q and Ye LY conducted the majority of study and wrote the manuscript; Xu YL, Wang L, Cao CH, Gao SL, Khoodoruth MAS and Ramjaun BZ revised the manuscript; Dong AQ offered suggestions for this work.
Supported by National Natural Science Foundation of China for Distinguished Young Scholars, No. 30925033; Innovation and High-Level Talent Training Program of Department of Health of Zhejiang Province, China
Correspondence to: Ting-Bo Liang, Professor, Department of Hepatobiliary-Pancreatic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang St, Hangzhou 310009, Zhejiang Province, China. liangtingbo@zju.edu.cn
Telephone: +86-571-87315006 Fax: +86-571-87315006
Received: June 13, 2013
Revised: July 24, 2013
Accepted: August 5, 2013
Published online: September 14, 2013
Processing time: 92 Days and 16.2 Hours
Abstract

Budd-Chiari syndrome (BCS) is defined as hepatic venous outflow obstruction at any level from the small hepatic veins to the junction of the inferior vena cava (IVC) and the right atrium, regardless of the cause of obstruction. We present two cases of acute iatrogenic BCS and our clinical management of these cases. The first case was a 43-year-old woman who developed acute BCS following the implantation of an IVC stent for the correction of stenosis in the IVC after hepatectomy for hepatolithiasis. The second case was a 61-year-old woman with complete obstruction of the outflow of hepatic veins during bilateral hepatectomy for hepatolithiasis. Acute iatrogenic BCS should be considered a rare complication following hepatectomy for hepatolithiasis. Awareness of potential hepatic outflow obstructions and timely management are critical to avoid poor outcomes when performing hepatectomy for hepatolithiasis.

Keywords: Acute iatrogenic Budd-Chiari syndrome; Hepatolithiasis; Hepatectomy; Inferior vena cava

Core tip: The occurrence of acute iatrogenic Budd-Chiari syndrome (BCS) following hepatectomy for hepatolithiasis is rarely reported. However, it may occur following a particularly difficult hepatectomy for complicated hepatolithiasis. Here, we report two cases of acute BCS and present our clinical experience in managing these cases.