A research team from France reported two cases of postoperative hepatic vein thrombosis after liver resection. They concluded that thrombosis of hepatic veins may occur after liver resection and is a potential source of pulmonary embolism.
Patients undergoing liver surgery have long been considered to be at low risk of venous thromboembolism. However, pulmonary embolism has recently emerged as an increasingly frequent and potentially fatal complication following liver resections.
A research article published on January 21, 2011 in the World Journal of Gastroenterology addresses this question. The authors shed a new light on this discrepancy by reporting two patients who developed thrombi in their hepatic veins following hepatectomy.
The report indicated that thrombosis may occur in hepatic veins after liver resection as a result of intra- or postoperative local injury. This would explain why pulmonary emboli have been observed in the absence of peripheral deep vein thrombosis. This hazard should be taken into account when performing extensive coagulation of the raw surface of the liver when a major hepatic vein is exposed.
Buc E, Dokmak S, Zappa M, Denninger MH, Valla DC, Belghiti J, Farges O. Hepatic veins as a site of clot formation following liver resection. World J Gastroenterol 2011; 17(3): 403-406. www.wjgnet.com/1007-9327/full/v17/i3/403.htm