Hepatic infarction from portal vein thrombosis: A fatal consequence of acute pancreatitis

Das, Somak; Swain, Sudeepta Kumar; Anand, Raktima

doi:10.1111/1751-2980.12474

Cited by 7 publications

(3 citation statements)

References 13 publications

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“…Previous studies have clearly demonstrated the risk factors, including red blood cell specific volume (HCT), D-dimer, serum amylase, APACHE-II score, and Ranson sore, for SVT or PSVT [ 21 , 22 ]. About one fourth of the patients developed variable symptomatic manifestations including gastrointestinal bleeding, persistent ascites, oral intake intolerance and even hepatic infarction [ 23 , 24 ]. In addition to SVT or PSVT, other venous thromboembolism (VTE) in necrotizing pancreatitis, including extremity deep venous thrombosis and pulmonary embolism was also common with the incidence of 16% and 6%, respectively [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic transgastric necrosectomy in treatment of walled-off pancreatic necrosis with sinistral portal hypertension

Cao

Wang

et al. 2021

BMC Surg

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Background Laparoscopic transgastric necrosectomy (LTGN) has been used in treatment of walled-off pancreatic necrosis (WON) for more than a decade. However, the safety and effectiveness of LTGN for WON with sinistral portal hypertension was still unclear. Methods WON patients with sinistral portal hypertension treated in our department between January 2011 and December 2018 were included and retrospectively analyzed in this study. Patients were divided into two groups according to different surgical approaches, LTNG or laparoscopic assisted trans-lesser sac necrosectomy (LATLSN). Perioperative and long-term outcomes were compared between two groups. Results 312 cases diagnosed with WON were screened and 53 were finally included in this study. Of the included patients, 21 and 32 cases were received LTGN and LATLSN, respectively. LTGN was associated with significantly lower morbidity than LATLSN (19.0% vs 46.9%, p = 0.04) and similar severe complication (Clavien–Dindo ≥ III) rate (12.5% vs 19.0%, p = 0.70). LTGN did not increase the rate of postoperative hemorrhage (9.5% vs 6.3%, p = 1.00) and mortality (9.5% vs 9.4%, p = 1.00). After 39 (11–108) months follow-up, the recurrence rate of WON and long-term complications were also comparable between groups. Conclusion From current data, LTGN was safe and effective in treatment of WON patients with sinistral portal hypertension in terms of short- and long-term outcomes.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic transgastric necrosectomy in treatment of walled-off pancreatic necrosis with sinistral portal hypertension

Cao

Wang

et al. 2021

BMC Surg

View full text Add to dashboard Cite

show abstract

“…Previous studies have clearly demonstrated the risk factors, including red blood cell speci c volume(HCT), D-dimer, serum amylase, APACHE-II score, and Ranson sore, for SVT or PSVT [19,20]. About one fourth of the patients developed variable symptomatic manifestations including gastrointestinal bleeding, persistent ascites, oral intake intolerance and even hepatic infarction [21,22]. In addition to SVT or PSVT, other venous thromboembolism(VTE) in necrotizing pancreatitis, including extremity deep venous thrombosis and pulmonary embolism was also common with the incidence of 16% and 6%,respectively [23].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Transgastric Necrosectomy in Treatment of Walled-off Pancreatic Necrosis with Sinistral Portal Hypertension: A Single-Center Retrospectively Study

Feng

Zheng

et al. 2020

Preprint

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Background: Laparoscopic transgastric necrosectomy (LTGN) has been used in treatment of walled-off pancreatic necrosis (WON) for more than a decade. However, the safety and effectiveness of LTGN for WON with sinistral portal hypertension was still unclear. Methods: WON patients with sinistral portal hypertension treated in our department between Jan. 2011 and Dec. 2018 were included and retrospective analyzed in this study. Patients were divided into two groups according to different surgical approaches, LTNG or laparoscopic assisted trans-lesser sac necrosectomy (LATLSN). Perioperative and long-term outcomes were compared between two groups. Results: 312 cases diagnosed with WON were screened and 53 were finally included in this study. Of the included patients, 21 and 32 cases were received LTGN and LATLSN, respectively. LTGN was associated with significantly lower morbidity than LATLSN (19.0% vs 46.9%, p=0.04) and similar sever complication (Clavien-Dindo≥Ⅲ) rate (12.5% vs 19.0%, p=0.70). LTGN did not increase the rate of postoperative hemorrhage (9.5% vs 6.3%, p=1.00) and mortality (9.5% vs 9.4%, p=1.00). After 39(11-108) months follow-up, the recurrence rate of WON and long-term complications were also comparable between groups. Conclusions: From current data, LTGN was safe and effective in treatment of WON patients with sinistral portal hypertension in terms of short- and long-term outcomes.

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“…The development of SVT may cause serious clinical consequences, such as persistent abdominal distention, intractable ascites, enteral nutrition intolerance, even upper gastrointestinal bleeding, small bowel ischemia and hepatic failure [ 6 ]. Although limited literature reported that the incidence of these potentially fatal consequences was relatively low [ 7 ], they were associated with unfavorable clinical outcomes, including increased mortality, prolonged intensive care unit (ICU) and hospital stays, and impaired quality of life [ 8 , 9 ]. Therefore, this subset of patients may merit therapeutic interventions.…”

Section: Introductionmentioning

confidence: 99%

Catheter-directed thrombolysis versus systemic anticoagulation in the treatment of symptomatic splanchnic venous thrombosis secondary to acute pancreatitis: a retrospective cohort study

et al. 2023

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Background Catheter-directed thrombolysis (CDT) has been an important therapy and seems effective in patients with splanchnic venous thrombosis (SVT) secondary to some diseases, but this intervention hasn’t been formally evaluated in the setting of acute pancreatitis (AP). Methods This was a retrospective study enrolled patients between January 2013 and December 2018. AP patients who developed SVT-induced symptoms, including intractable ascites and/or enteral nutrition intolerance, were included. Demographics, SVT associated parameters, clinical features and outcomes, long-term quality of life evaluated by using SF-36 questionnaire were compared between CDT group and systemic anticoagulation (SAC) group. Results 6 patients underwent CDT and 17 received SAC. Patients in CDT group had a higher recanalization rate (100% versus 35.3%; p = 0.014) and shorter time to symptoms resolution (median 8 days versus. 31.5 days, p = 0.004). Mortality and length of hospital stay were comparable between two groups. The association analysis indicated that CDT use exerted a significantly beneficial effect on recanalization rate (risk ratio, 2.833; 95% CI, 1.489 to 5.393; p = 0.002) and time to symptoms resolution (mean difference, -33.333; 95% CI, -64.612 to -2.055; p = 0.038). No SVT-related symptoms recurrence was recorded in survivors at six-month follow-up. There was no statistical difference in either item of SF-36 questionnaire between two groups. Conclusions Compared with SAC, CDT may facilitate vascular recanalization and shorten symptom resolution for symptomatic SVT.

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Hepatic infarction from portal vein thrombosis: A fatal consequence of acute pancreatitis

Cited by 7 publications

References 13 publications

Laparoscopic transgastric necrosectomy in treatment of walled-off pancreatic necrosis with sinistral portal hypertension

Laparoscopic transgastric necrosectomy in treatment of walled-off pancreatic necrosis with sinistral portal hypertension

Laparoscopic Transgastric Necrosectomy in Treatment of Walled-off Pancreatic Necrosis with Sinistral Portal Hypertension: A Single-Center Retrospectively Study

Catheter-directed thrombolysis versus systemic anticoagulation in the treatment of symptomatic splanchnic venous thrombosis secondary to acute pancreatitis: a retrospective cohort study

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