Zhao D, Huang YM, Liang ZM, Zhang KJ, Fang TS, Yan X, Jin X, Zhang Y, Tang JX, Xie LJ, Zeng XC. Reconstructing the portal vein through a posterior pancreatic tunnel: New choice for portal vein thrombosis during liver transplantation. World J Gastrointest Surg 2022; 14(10): 1131-1140 [PMID: 36386397 DOI: 10.4240/wjgs.v14.i10.1131]
Corresponding Author of This Article
Dong Zhao, MD, Professor, Surgeon, Department of Liver Surgery and Organ Transplantation Center, The Third People’s Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Disease, No. 29 Bulan Road, Longgang District, Shenzhen 518000, Guangdong Province, China. zdong1233@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Oct 27, 2022; 14(10): 1131-1140 Published online Oct 27, 2022. doi: 10.4240/wjgs.v14.i10.1131
Table 1 Basic demographics and clinical data of cases with portal vein thrombosis (n = 7)
Gender
Age
Diagnosis
Operation time (s)
Anhepatic stage (s)
Intraoperative blood loss (mL)
Transfusion of red blood cell suspension (U)
Cold ischemia time (s)
Outcome
Case 1
Male
65
HBV-related decompensated liver cirrhosis, HCC
648
34
1300
10
510
Survival
Case 2
Male
48
HBV-related decompensated liver cirrhosis
756
31
1000
6
480
Survival
Case 3
Male
38
HBV-related decompensated liver cirrhosis
564
35
800
0
390
Death
Case 4
Female
64
HBV-related decompensated liver cirrhosis, HCC
585
25
600
0
360
Survival
Case 5
Male
57
HBV-related decompensated liver cirrhosis, HCC
583
47
600
0
360
Survival
Case 6
Male
54
HBV-related decompensated liver cirrhosis
491
30
500
0
360
Survival
Case 7
Male
51
HBV-related decompensated liver cirrhosis, HCC
625
34
3000
20
360
Survival
Table 2 Vascular anatomical changes in the portal vein system of cases with portal vein thrombosis (n = 7)
Case
Left gastric vein (coronary vein)
Esophagogastric fundus vein
Superior mesenteric vein
Splenic vein
Shunt situation
Drain into the main portal vein
Drain into the confluence of SMV and SpV
Drain into SpV
Maximum diameter of the blood vessel (mm)
Degree of varicose veins
History of upper gastrointestinal bleeding
With or without thrombus
Maximum diameter (mm)
With or without thrombus
Maximum diameter (mm)
With or without splenorenal shunt
Maximum diameter of the shunt (mm)
With or without umbilical vein opening
1
Yes
30
Severe
Yes
No
18.8
No
21.3
Yes
21
No
2
Yes
10.4
Severe
Yes
Yes
17
No
14.2
Yes
24
Yes
3
Yes
24.2
Severe
Yes
No
15.4
No
12.4
Yes
15.7
No
4
Yes
13.8
Severe
Yes
Yes
10.8
No
10.5
Yes
17.3
No
5
Yes
5.9
Severe
No
No
16.4
No
12.5
Yes
11.2
Yes
6
Yes
6.9
Mild
No
No
11
No
18.4
Yes
15.6
No
7
Yes
8.2
Severe
Yes
No
13.1
No
17.1
Yes
7.6
No
Table 3 Laboratory examination indicators on postoperative day 7
ALB (g/L)
TB (μmol/L)
DB (μmol/L)
ALT (U/L)
AST (U/L)
GGT (U/L)
PT (s)
INR
Case 1
32
98
52
111
43
78
20.4
1.72
Case 2
31.4
11.2
4.9
49
24
85
16.6
1.36
Case 3
38.1
27.8
18.3
204
63
236
18.9
1.61
Case 4
35.1
35.1
22.8
224
175
741
16.4
1.30
Case 5
35.3
39.5
23.1
169
41
89
15.9
1.25
Case 6
50
26.8
14.7
329
62
355
14.8
1.19
Case 7
35
20.1
13.5
48
20
328
15.4
1.21
Table 4 Laboratory examination indicators on postoperative day 14
ALB (g/L)
TB (μmol/L)
DB (μmol/L)
ALT (U/L)
AST (U/L)
GGT (U/L)
PT (s)
INR
Case 1
33
66
37
58
21
128
17.6
1.42
Case 2
38.3
12.1
5.2
35
15
75
14
1.09
Case 3
42.1
567
226
246
115
232
52.2
6.0
Case 4
34.3
80
54
135
87
677
15.1
1.18
Case 5
39.1
24.2
13.2
27
21
39
14
1.20
Case 6
39.8
13.8
11.2
57
53
140
13.6
1.12
Case 7
34.5
13.8
8.6
37
15
238
14.7
1.14
Citation: Zhao D, Huang YM, Liang ZM, Zhang KJ, Fang TS, Yan X, Jin X, Zhang Y, Tang JX, Xie LJ, Zeng XC. Reconstructing the portal vein through a posterior pancreatic tunnel: New choice for portal vein thrombosis during liver transplantation. World J Gastrointest Surg 2022; 14(10): 1131-1140