Infrahepatic Inferior Vena Cava Clamping does not Increase the Risk of Pulmonary Embolism Following Hepatic Resection

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Emrullah Birgin - , Universität Heidelberg (Autor:in)
  • Arianeb Mehrabi - , Universität Heidelberg (Autor:in)
  • Dorothée Sturm - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie (Autor:in)
  • Christoph Reißfelder - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie (Autor:in)
  • Jürgen Weitz - , Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Nuh N. Rahbari - , Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)

Abstract

Background: Infrahepatic inferior vena cava (IVC) clamping reduces central venous pressure. However, controversies remain regarding its impact on postoperative complications, particularly, the incidence of postoperative pulmonary embolism (PE). The aim of the study was to determine the impact of IVC clamping on the incidence of PE in patients undergoing hepatectomy. Methods: A pooled analysis of five prospective trials on patients who underwent hepatic resection over a period of 10 years was performed. Patients with infrahepatic IVC clamping were compared to patients without infrahepatic IVC clamping. Outcomes were studied by univariate and multivariate analyses. Results: Of 505 included patients, 141 patients had IVC clamping and 364 patients served as control group. The rate of postoperative PE was comparable between groups (3% vs. 3%; P = 0.762), as were postoperative morbidity (P = 0.932), bile leakage (P = 0.272), posthepatectomy hemorrhage (P = 0.095), and posthepatectomy liver failure (P = 0.605), respectively. No clinicopathological and intraoperative risk factors were found to predict the onset of PE. Subgroup analyses of patients with major hepatectomy and vascular resections confirmed no adverse perioperative outcomes to be associated with IVC clamping. Conclusions: Infrahepatic IVC clamping does not increase the incidence of postoperative PE.

Details

OriginalspracheEnglisch
Seiten (von - bis)2911-2923
Seitenumfang13
FachzeitschriftWorld journal of surgery
Jahrgang45
Ausgabenummer9
PublikationsstatusVeröffentlicht - Sept. 2021
Peer-Review-StatusJa

Externe IDs

PubMed 34047820

Schlagworte

ASJC Scopus Sachgebiete