Complications of endobiliary minimally invasive percutaneous procedures

Objective. To improve the outcomes of percutaneous endobiliary interventions through prediction of postoperative complications and searching for minimally invasive methods of their treatment. Material and methods. Percutaneous en dobiliary interventions have been performed in 2458 patients for the period from 2006 to 2018 including bile duct stenting in 1895 patients. Results. Early postoperative complications included hemobilia (2.1%), abdominal bleeding (0.2%), duodenal bleeding (0.1%), pleuritis (0.9%), abdominal bile leakage (1.5%) and peritonitis (0.8%), liver hematoma (0.7%), right-sided pleuritis (0.9%), pancreatitis (13.8%). In our opinion, these complications are serious and require immediate intensive care and invasive repair. Mortality rate was 8.4% among all patients with early complications and 0.9% among those after endobiliary interventions. Delayed complications of percutaneous transhepatic interventions are migration of stent or drainage tube, drain incrustation, malignant invasion of stent, recurrent cholangitis, cholangiogenic liver abscesses, abdominal abscesses, sepsis, fragmentation of drain or stent, portal vein thrombosis. The most severe late complications (sepsis and portal vein thrombosis) resulted mortality rate 50–60%. Conclusion. Combined dual (ante- and retrograde) biliary approach and control throughout minimally invasive surgery eliminate disadvantages of individual accesses, reduce invasiveness, postoperative morbidity and mortality.

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Imaging and minimally invasive endovascular therapy in the management of portal vein thrombosis

Abdominal Radiology ◽

10.1007/s00261-017-1335-9 ◽

2017 ◽

Vol 43 (8) ◽

pp. 1931-1946 ◽

Cited By ~ 3

Author(s):

Susana G. Rodrigues ◽

Martin H. Maurer ◽

Iris Baumgartner ◽

Andrea De Gottardi ◽

Annalisa Berzigotti

Keyword(s):

Minimally Invasive ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Endovascular Therapy ◽

Vein Thrombosis

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Chronic Portal Vein Thrombosis After Liver Transplantation in a Child Treated by a Combined Minimally Invasive Approach

CardioVascular and Interventional Radiology ◽

10.1007/s00270-009-9578-7 ◽

2009 ◽

Vol 32 (5) ◽

pp. 1083-1086 ◽

Cited By ~ 5

Author(s):

Francisco Cesar Carnevale ◽

Aline Cristine Barbosa Santos ◽

Charles Edouard Zurstrassen ◽

Airton Mota Moreira ◽

João Seda Neto ◽

...

Keyword(s):

Liver Transplantation ◽

Minimally Invasive ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Vein Thrombosis

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Transcatheter recanalization with angioplasty and/or stenting: a novel, minimally-invasive treatment option for children with chronic portal vein thrombosis with cavernous transformation

Journal of Hepatology ◽

10.1016/s0168-8278(18)31513-7 ◽

2018 ◽

Vol 68 ◽

pp. S628-S629

Author(s):

H. Justino ◽

K. Kukreja ◽

J.A. Hernandez ◽

Y. Pham ◽

S. Harpavat ◽

...

Keyword(s):

Minimally Invasive ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Treatment Option ◽

Minimally Invasive Treatment ◽

Invasive Treatment ◽

Vein Thrombosis ◽

Cavernous Transformation

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The Management of Portal Vein Thrombosis after Adult Liver Transplantation: A Case Series and Review of the Literature

10.21203/rs.3.rs-118175/v1 ◽

2020 ◽

Author(s):

Qingshan Li ◽

Wanli Wang ◽

Tao Ma ◽

Yue Wang ◽

Yifan Yang ◽

...

Keyword(s):

Liver Transplantation ◽

Minimally Invasive ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Case Series ◽

Interventional Therapy ◽

Review Of The Literature ◽

Adult Liver ◽

Vein Thrombosis ◽

Systemic Anticoagulation

Abstract Background: Portal vein thrombosis (PVT) after adult liver transplantation (LT) is a rare but serious complication with no consensus on the ideal treatment. We report a case series and a comprehensive review of the literature on PVT after LT to discuss the therapeutic options. Methods: The clinical data of 360 adult patients (≥18 years of age) that underwent LT from January 2015 to January 2018 were reviewed, and a comprehensive search of PubMed and Web of Science was conducted. Patients diagnosed with PVT after LT were identified, and relevant risk factors and therapies were analyzed. Results: Among the 360 patients, seven (2.69%) developed PVT after LT. The onset of PVT within one week after LT was found in six patients (85.71%). Four of these seven patients with PVT received systemic anticoagulation (low molecular weight heparin and warfarin) therapy. Minimally invasive interventional therapies combined with systemic anticoagulation (heparin and warfarin) were applied to three patients, two of whom died because of severe abdominal hemorrhage and liver failure. In the 29 cases reported in the literature, minimally invasive interventional therapy combined with systematic anticoagulation or sclerotherapy were the most used methods (19/29). Systemic anticoagulation was administered to three patients, surgical operation (thrombectomy; portosystemic shunt and retransplantation) was performed for seven patients. Among these 29 patients, four eventually died. Conclusions: In conclusion, interventional therapy combined with systemic anticoagulation is a good choice for the management of PVT after LT, and in our experience, systemic anticoagulation alone can also have a positive effect for early PVT patients.

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Portal vein thrombosis and food protein-induced allergic proctocolitis in a premature newborn with hypereosinophilia: a case report

BMC Pediatrics ◽

10.1186/s12887-021-02510-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Cheong-Jun Moon ◽

Tae Hee Kwon ◽

Hyun-Seung Lee

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Expectant Management ◽

Late Complications ◽

Food Protein ◽

Thrombotic Risk ◽

Premature Newborn ◽

Vein Thrombosis ◽

Tissue Eosinophilia ◽

Allergic Proctocolitis

Abstract Background Peripheral blood eosinophilia is identified in numerous medical conditions associated with allergic, infectious, and inflammatory processes mostly as reactive eosinophilia with or without tissue eosinophilia. In hospitalized neonates, eosinophilia is common with an inverse relationship with gestational age and occurs solely as mild eosinophilia in the majority of cases. In the literature, eosinophilia has been proposed as a possible risk factor for venous thromboembolism. However, few reports are found on thromboembolic events including portal vein thrombosis (PVT) associated with eosinophilia in the newborn period. Neonates, particularly preterm infants, are vulnerable to thrombosis due to the immature and developing hemostatic system with little reserve capacity, which occurs as catheter-related thrombosis in most cases. Case presentation A male newborn at 34+ 5 weeks’ gestation presented with a left portal venous thrombus and hematochezia after initial cow’s milk feeding in the setting of blood hypereosinophilia for a prolonged period of time without central venous catheterization. The infant was diagnosed with PVT and food protein-induced allergic proctocolitis (FPIAP) and showed complete resolution of the conditions with expectant management with food avoidance, including the normalized eosinophil count. Conclusions Our experience suggests that in the setting of hypereosinophilia with a prolonged duration in premature neonates, FPIAP should be suspected in case of hematochezia in otherwise healthy infants, and considering the increased thrombotic risk by the hypereosinophilia and premature newborn status, evaluation for neonatal thrombosis may be needed, including PVT with the potential risk for the more serious, but uncommon, late complications encompassing portal hypertension.

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