Oguz Sukru, Küçükaslan Hakan, Altun Gokalp, Basar Dilek, Topaloglu Serdar, Calik Adnan
Department of Radiology, School of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey.
Department of Surgery, Trabzon Akçaabat Haçkalı Baba Devlet Hastanesi, Trabzon 61080, Turkey.
BJR Case Rep. 2025 Mar 20;11(2):uaaf017. doi: 10.1093/bjrcr/uaaf017. eCollection 2025 Mar.
Currently, portal vein (PV) resection is performed in 10%-40% of liver resections performed for hilar cholangiocarcinoma (HC). The defect is generally repaired with a patch of an autologous vein graft or end-to-end anastomosis after complete separation of the main PV trunk and the left PV. Postoperative PV thrombosis is a severe complication occurring in 2%-9% of patients requiring PV reconstruction. Here in, we presented a 55-year-old man with abdominal pain without hyperbilirubinaemia who was diagnosed with HC. The patient underwent right hepatectomy, extrahepatic biliary resection, and PV resection. The PV defect was repaired with autologous umbilical vein graft. Following the operation, acute PV thrombosis was encountered postoperative day 1. We conducted the treatment of the early acute PV thrombosis by intraportal tPA and PV stenting with endovascular approach.
目前，在为肝门部胆管癌（HC）进行的肝切除术中，10% - 40%的手术会进行门静脉（PV）切除。缺损通常在主PV干和左PV完全分离后，用一块自体静脉移植物修补或进行端端吻合来修复。术后PV血栓形成是一种严重并发症，在需要PV重建的患者中发生率为2% - 9%。在此，我们报告一名55岁男性，有腹痛但无高胆红素血症，被诊断为HC。该患者接受了右半肝切除术、肝外胆管切除术和PV切除术。PV缺损用自体脐静脉移植物修复。术后第1天出现急性PV血栓形成。我们通过门静脉内注射组织型纤溶酶原激活剂（tPA）和采用血管内介入方法进行PV支架置入术对早期急性PV血栓形成进行了治疗。
