Portal vein thrombosis formation in patients submitted to portal hypertension operation

Objective To investigate the incidence and causes of postoperative portal vein thrombosis(PVT) in patients after shunting and(or) devascularization operations.Methods Two hundred and thirty-three cases of portal hypertension undergoing either proximal spleno-renal shunt combined with pericardial devascularization(PSRS plus PCDV) or PCDV alone were retrospectively analyzed.The blood flow velocity of portal venous system was determined by magnetic resonance angiography.Results The incidence of PVT in PCDV group was 91.06%.Among these cases,the incidence of thrombosis formed in the splenic vein and the portal vein trunk was 100% and 25.89%,respectively.The incidence of PVT in PSRS plus PCDV group was 10.91%.The blood flow velocity in the portal vein(PV) and the splenic vein(SV) was significantly decreased after thrombosis formation,and more significantly in the SV,as compared with those without thrombosis.However,no differences were found in blood platelet count and prothrombin time(PT) between these two groups.Conclusions Changes of portal hemodynamics play an important role in the PVT formation postoperatively and thrombocytosis is not the main reason.PSRS plus PCDV is a practical operation in decreasing the incidence of PVT.