Risk Factors and Anticoagulation Effects of Portal Vein System Thrombosis After Laparoscopic Splenectomy in Patients With or Without Cirrhosis
The clinical data of 149 patients who underwent successful laparoscopic splenectomy (LS) between January 2014 and September 2017 were analyzed in the present study. The incidence of portal vein system thrombosis (PVST) in patients with and without cirrhosis was 32.0% and 9.5%, respectively. Multiple logistic regression analysis revealed that the ratio of the postoperative maximum platelet (PLT) count to the preoperative PLT count (r=1.144; P=0.007) was the risk factor for PVST in all patients after LS. Of patients who received prophylactic anticoagulation, 9 and 6 cases of PVST in patients with and without cirrhosis, respectively, (37.5% vs. 85.7%; P=0.037) resolved during hospitalization. In patients who underwent LS, a PLT count increasing to>8 times baseline levels after surgery was the risk factor for PVST after LS, and the sensitivity to anticoagulation postoperatively was significantly higher in patients without cirrhosis than in those with cirrhosis.
Recommendations address bleeding and thrombotic risk in cirrhosis; portal, mesenteric vein thrombosis
In conclusion DOACs appear to be a safe alternative to warfarin in patients with mild to moderate cirrhosis. Further studies are warranted to confirm these findings.
Conclusion A collaborative relationship between reconstructive microsurgeons and transplant surgeons mitigates the risk of HAT and improves patient outcomes in living donor liver transplantation. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Abstract | Full text
In this study, we examined...
Aim The differences of the clinical features and survival outcomes between cirrhotic and noncirrhotic hepatocellular carcinoma (HCC) patients with hepatitis B virus (HBV) infection remain to be determined. We evaluated clinical characteristics and survival outcomes of noncirrhotic HBV-associated HCC patients compared with cirrhotic patients. Patients and methods Between January 2005 and December 2015, 1345 patients were diagnosed to have HCC at our hospital. Of these, 860 HBV-associated HCC patients with (cirrhotic group, n = 519, 60.3%) or without cirrhosis (noncirrhotic group, n = 341, 39...
Conclusions. The eNO level was increased in cirrhotic patients, especially in those complicated with ascites, portal vein thrombosis, mucosal red-color sign of varices, and high HVPG. PMID: 31781658 [PubMed - in process]
Rationale: Despite vast improvements in technique, several complications still challenge surgeons and medical practitioners alike, including biliary and vascular complications, acute and chronic rejection, and disease recurrence. Patient concerns: A 59-year-old man was admitted to hospital on July, 2016. He had hepatitis B cirrhosis related recurrent hepatocellular carcinoma and underwent living donor liver transplantation in our hospital. Diagnosis: At the time of admission, the patient's spirit, diet, sleep, normal urine and stool, and weight did not change significantly. The test indicators are as follows: total...
This article revises the characteristics of portal vein thrombosis on contrast-enhanced ultrasonography in order to determine its accuracy in the diagnosis of malignant portal vein thrombosis.
Conclusion and Relevance: Patients with severe cirrhosis required higher doses of heparin to achieve the same therapeutic AXA levels, but also tended to have higher rates of bleeding compared with less severe cirrhosis. These results represent further evidence of changes in heparin response as cirrhosis severity increases and may suggest that current monitoring methods are suboptimal in this patient population. PMID: 31766856 [PubMed - as supplied by publisher]
Conditions: Liver Cirrhosis; Portal Vein Thrombosis Intervention: Drug: Low molecular weight heparin (LMWH), warfarin Sponsor: Qilu Hospital of Shandong University Recruiting