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Infrahepatic Inferior Vena Cava Clamping does not Increase the Risk of Pulmonary Embolism Following Hepatic Resection
- Source :
- World Journal of Surgery
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
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.
- Subjects :
- medicine.medical_specialty
Original Scientific Report
medicine.medical_treatment
Blood Loss, Surgical
Vena Cava, Inferior
Inferior vena cava
medicine
Hepatectomy
Humans
Prospective Studies
business.industry
Central venous pressure
Perioperative
medicine.disease
Constriction
Pulmonary embolism
Surgery
Cardiac surgery
medicine.vein
Cardiothoracic surgery
cardiovascular system
Pulmonary Embolism
business
Abdominal surgery
Subjects
Details
- ISSN :
- 14322323 and 03642313
- Database :
- OpenAIRE
- Journal :
- World Journal of Surgery
- Accession number :
- edsair.doi.dedup.....3a788e4a612a1794febb8892531f9a26
- Full Text :
- https://doi.org/10.1007/s00268-021-06159-4