Prospective validation to prevent symptomatic portal vein thrombosis after liver resection

Table 1 Risk factors associated with portal vein thrombosis after liver resection

Variables	Univariate analyses			Multivariate analyses
	PVT (+), n = 8	PVT (-), n = 227	P value	OR	95%CI	P value
Back ground characteristics
Age	69.9 ± 3.4	67.8 ± 0.6	0.54
Male sex	4 (50.0%)	181 (79.7%)	0.04	0.25	0.05-1.29	0.10
Hepatocellular carcinoma (+)	7 (87.5%)	190 (73.7%)	0.77
Multiple tumor	2 (25.0%)	72 (31.7%)	0.69
Heavy drinker	2 (25.0%)	55 (24.2%)	0.96
Portal vein embolization	0	12 (5.3%)	0.50
Body mass index	24.8 ± 1.2	23.7 ± 0.2	0.39
Preoperative anticoagulant therapy	1 (12.5%)	10 (4.4%)	0.29	7.95	0.32-106.81	0.17
Diabetes mellitus	2 (25.0%)	92 (40.5%)	0.38
HBsAg (+)	1 (12.5%)	39 (17.2%)	0.73
HCVAb (+)	2 (25.0%)	52 (22.9%)	0.89
Platelet count as × 104/μL	18.6 ± 7.8	21.4 ± 1.5	0.72
Albumin in g/dL	4.2 ± 0.2	4.2 ± 0.03	0.79
Total bilirubin in mg/dL	0.7 ± 0.2	0.7 ± 0.03	0.92
Prothrombin time, %	93.8 ± 3.8	93.4 ± 0.7	0.94
D-dimer in ng/mL	1.7 ± 0.8	1.7 ± 0.2	0.97
ICGR15, %	15.0 ± 2.2	11.7 ± 0.4	0.14	0.91	0.82-1.02	0.09
Liver damage B	0	10 (6.3%)	0.53
Procedure
Anatomical resection	6 (75.0%)	159 (70.0%)	0.76
Segmentectomy	0	48 (21.2%)	0.14
Sectiontectomy	6 (75.0%)	55 (24.2%)	0.001	12.20	2.22-115.97	0.003
Hemihepatectomy	0	56 (24.7%)	0.11
Surgical outcomes
Operatin time in min	324 ± 40	374 ± 8	0.21
Hepatic clamping time in min	76 ± 15	89 ± 3	0.38	1.01	0.99-1.03	0.56
Blood loss in g	517 ± 186	455 ± 35	0.74
RBC transfusion	1 (12.5%)	13 (5.7%)	0.43
Surgical results
Complication CD ≥ 3a	3 (37.5%)	50 (22.0%)	0.30
Bile leakage	2 (25.0%)	26 (11.5%)	0.25	3.12	0.35-21.58	0.28
Mortality	0	2 (0.9%)	0.79
Histological cirrhosis	1 (12.5%)	32 (14.1%)	0.90

CD: Clavian-Dindo classification; CI: Confidence interval; HBsAg: Hepatitis B surface antigen; HCVAb: Hepatitis C virus antibody; OR: Odds ratio; PVT: Portal vein thrombosis; RBC: Red blood cell.

Table 2 Comparisons of left and right sides for each procedure

		PVT (+), n = 8	PVT (-), n = 227	P value	OR	95%CI
Partial resection		2 (25.0%)	68 (30.0%)	0.76	0.78	0.15-3.96
Segmentectomy	Left	-	8 (3.5%)	0.59
	Right	-	40 (17.6%)	0.19
Sectiontectomy	Left	5 (62.5%)	24 (10.6%)	< 0.0001	14.10	3.17-62.71
	Right	1 (12.5%)	31 (13.7%)	0.93	0.90	0.11-7.60
Hemihepatectomy	Left	-	37 (16.3%)	0.21
	Right	-	19 (8.4%)	0.39

CI: Confidence interval; OR: Odds ratio; PVT: Portal vein thrombosis.

Table 3 Portal vein thrombosis cases, treatments, and outcomes

Case	No. of patients	Age	Sex	Diagnosis	Extent of resection	PVT location	Anticoagulation	Outcome	PVT treatment period in d
1	65	71	Male	HCC	Left medial sectionectomy	UP	Heparin, warfarin	Resolved	53
2	135	83	Male	ICC	Left lateral sectionectomy	Lt branch, UP	Heparin, warfarin	Resolved	37
3	151	50	Female	HCC	Left lateral sectionectomy, partial resection (S1)	UP	Heparin, warfarin	Resolved	63
4	214	75	Female	HCC	Left lateral sectionectomy	UP	Warfarin	Resolved	59
5	385	78	Female	HCC	Partial resection (S8)	P8 stump	Edoxaban	Stable	46
6	391	70	Male	HCC	Right posterior sectionectomy	Anterior branch	Heparin, warfarin	Resolved	44
7	417	75	Female	HCC	Partial resection (S4, S7)	UP	Heparin, edoxaban	Resolved	140
8	475	57	Male	HCC	Left medial sectionectomy	UP	Heparin, edoxaban	Resolved	58

HCC: Hepatocellular carcinoma; ICC: Intrahepatic cholangiocarcinoma; PVT: Portal vein thrombosis; UP: Umbilical potion.