Incidence, risk factors and outcomes for post-hepatectomy portal vein thrombosis: A retrospective study

Post-hepatectomy portal vein thrombosis (PH-PVT) is a life-threatening complication; however, the available literature on this topic is limited.

To examine the incidence, risk factors, and outcomes associated with PH-PVT.

Medical records of patients who underwent hepatic resection for various diseases between February 2014 and December 2023 at Beijing Tsinghua Changgung Hospital affiliated with Tsinghua University (Beijing, China) were retrospectively reviewed. The patients were divided into a PH-PVT group and a non-PH-PVT group. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for PH-PVT.

A total of 1064 patients were included in the study cohort, and the incidence and mortality rates of PH-PVT were 3.9% and 35.7%, respectively. The median time from hepatectomy to the diagnosis of PH-PVT was 6 days. Multivariate analysis revealed that hepatectomy combined with pancreaticoduodenectomy (HPD) [odds ratio (OR) = 7.627 (1.390-41.842), P = 0.019], portal vein reconstruction [OR = 6.119 (2.636-14.203), P < 0.001] and a postoperative portal vein angle < 100° [OR = 2.457 (1.131-5.348), P = 0.023] were independent risk factors for PH-PVT. Age ≥ 60 years [OR = 8.688 (1.774-42.539), P = 0.008] and portal vein reconstruction [OR = 6.182 (1.246-30.687), P = 0.026] were independent risk factors for mortality in PH-PVT patients.

Portal vein reconstruction, a postoperative portal vein angle < 100° and HPD were independent risk factors for PH-PVT. Age ≥ 60 years and portal vein reconstruction were independent risk factors for mortality in PH-PVT patients.