Portal Vein Thrombosis After Splenic and Pancreatic Surgery

Adv Exp Med Biol. 2017:906:241-251. doi: 10.1007/5584_2016_119.

Abstract

The portal vein is formed by the confluence of the splenic and superior mesenteric veins, which drain the spleen and small intestine respectively. Occlusion of the portal vein by thrombus typically occurs in patients with cirrhosis and/or prothrombotic disorders. However, portal vein thrombosis (PVT) can also happen after determined surgeries. Moreover, PVT can have serious consequences depending on the location and extent of the thrombosis, including hepatic ischemia, intestinal ischemia, portal hypertension… In this chapter, we will review the incidence, management and prophylaxis of PVT after splenectomy, pancreas transplantation, pancreatic surgery and in the setting of acute and chronic pancreatitis.

Keywords: Laparoscopy; Pancreatic neoplasms; Pancreatic surgery; Portal vein thrombosis; Prophylaxis; Splenic surgery.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use*
  • Heparin, Low-Molecular-Weight / therapeutic use*
  • Humans
  • Hypertension, Portal / complications
  • Hypertension, Portal / pathology
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / surgery
  • Pancreas / blood supply
  • Pancreas / pathology
  • Pancreas / surgery
  • Pancreas Transplantation / adverse effects*
  • Pancreatectomy / adverse effects*
  • Pancreatitis / complications
  • Pancreatitis / pathology
  • Portal Vein / diagnostic imaging
  • Portal Vein / pathology
  • Portal Vein / surgery
  • Risk Factors
  • Spleen / blood supply
  • Spleen / pathology
  • Spleen / surgery
  • Splenectomy / adverse effects*
  • Thrombectomy
  • Ultrasonography, Doppler
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / etiology
  • Venous Thrombosis / pathology
  • Venous Thrombosis / therapy*

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight