Abstract
Background
The incidence of vascular injury after a cholecystectomy is often underestimated.
Although injuries to the portal vein are rare, they are devastating. The aim of the
present study was to analyze suitable therapeutic strategies regarding portal vein
injury in the absence of biliary injury.
Materials and methods
Eleven patients with portal vein injuries after laparoscopic or open cholecystectomy
were referred to our hospital between 2004 and 2010. The clinical presentation, diagnosis,
and management of patients with severe portal vein injuries were reviewed. All the
patients were discharged without outstanding clinical conditions. During retrospective
analysis, these patients were divided into early, middle, and late stages.
Results
All the 11 patients had a portal vein and/or right hepatic artery injury, but no biliary
injuries were observed. Among these patients, different management strategies were
managed according to the stage of the injury. Eight patients received a direct suture
at the time of injury by an experienced hepatobiliary surgeon. Two patients received
thrombolytic and anticoagulation therapy after cholecystectomy, without additional
surgery. One patient received a liver transplant 3 mo after the injury. After long-term
follow-up, these patients had no clinical conditions.
Conclusions
Direct repair or suture is important during the early stage of portal vein injury.
Conservative thrombolytic and anticoagulation therapy may serve an important role
in the treatment of acute massive thrombus in portal vein injury during the middle
stage. Liver transplantation is a salvage therapy that should be used during the late
stage.
Keywords
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Article info
Publication history
Published online: July 08, 2013
Accepted:
June 13,
2013
Received in revised form:
June 11,
2013
Received:
April 2,
2013
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
