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

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Emrullah Birgin - , Heidelberg University  (Author)
  • Arianeb Mehrabi - , Heidelberg University  (Author)
  • Dorothée Sturm - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)
  • Christoph Reißfelder - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)
  • Jürgen Weitz - , Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus Dresden (Author)
  • Nuh N. Rahbari - , University Hospital Carl Gustav Carus Dresden (Author)

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

Original languageEnglish
Pages (from-to)2911-2923
Number of pages13
JournalWorld journal of surgery
Volume45
Issue number9
Publication statusPublished - Sept 2021
Peer-reviewedYes

External IDs

PubMed 34047820

Keywords

ASJC Scopus subject areas