BACKGROUND The thrombosis of the main and intrahepatic branches of the portal vein (TMIP) is potentially lethal and deemed a common complication following laparoscopic splenectomy and azygoportal disconnection (LSD) in patients with cirrhosis and portal hypertension (PH). The predictors of TMIP after LSD remain unclear. The aim of this prospective study was to explore the predictive and risk factors for TMIP after LSD in cirrhotic patients with PH caused only by hepatitis B virus. METHODS From September 2014 to March 2017, we enrolled 115 patients with hepatitis B cirrhosis and PH who successfully underwent LSD. Patients were subdivided into a TMIP group and a non-TMIP group. Univariate and multivariate logistic regression analysis was conducted on 24 items of demographic and preoperative data, to explore the risk factors of TMIP. RESULTS Twenty-nine (25.22%) patients developed TMIP on postoperative day (POD) 7 and 26 (22.81%) patients developed TMIP on POD 30. From POD 7 to POD 30, 12 patients who did not have TMIP at POD 7 were newly diagnosed with TMIP, with portal vein diameter 15.05 ± 2.58 mm. Another 14 patients in whom TMIP had resolved had portal vein diameter 14.02 ± 1.76 mm. Univariate analysis and multivariate logistic regression revealed that portal vein diameter ≥ 13 mm [relative risk (RR) 5.533, 95% confidence interval (CI) 1.222-25.042; P = 0.026] and portal vein diameter ≥ 15 mm (RR 3.636, 95% CI 1.466-9.021; P = 0.005) were significant independent risk factors for TMIP on POD 7 and 30, respectively. CONCLUSION Portal vein diameter ≥ 13 mm and ≥ 15 mm were significant independent predictors for TMIP after LSD in patients with hepatitis B cirrhosis and PH on POD 7 and POD 30, respectively. TRIAL REGISTRATION We registered our research at https://www. CLINICALTRIALS gov/ . The name of research registered is "Warfarin Prevents Portal Vein Thrombosis in Patients After Laparoscopic Splenectomy and Azygoportal Disconnection." The trial registration identifier at clinicaltrials.gov is NCT02247414.

中文翻译：

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乙型肝炎肝硬化腹腔镜脾切除术和奇门静脉断开后门静脉血栓形成的预测因素：一项前瞻性研究。

背景 门静脉主要分支和肝内分支 (TMIP) 的血栓形成可能致命，并且被认为是肝硬化和门脉高压 (PH) 患者腹腔镜脾切除术和奇静脉门静脉断开 (LSD) 后的常见并发症。LSD 后 TMIP 的预测因子仍不清楚。本前瞻性研究的目的是探讨仅由乙型肝炎病毒引起的 PH 肝硬化患者 LSD 后 TMIP 的预测因素和危险因素。方法 从 2014 年 9 月到 2017 年 3 月，我们招募了 115 名成功接受 LSD 治疗的乙型肝炎肝硬化和 PH 患者。患者被细分为 TMIP 组和非 TMIP 组。对24项人口学及术前资料进行单因素和多因素logistic回归分析，探讨TMIP的危险因素。结果 29 名 (25.22%) 患者在术后第 7 天 (POD) 出现 TMIP，26 名 (22.81%) 患者在术后第 30 天出现 TMIP。从 POD 7 到 POD 30，12 名在 POD 7 没有出现 TMIP 的患者是新出现的诊断为 TMIP，门静脉直径为 15.05 ± 2.58 mm。另外 14 名 TMIP 已解决的患者的门静脉直径为 14.02 ± 1.76 mm。单变量分析和多变量 logistic 回归显示门静脉直径≥13 mm [相对风险 (RR) 5.533，95% 置信区间 (CI) 1.222-25.042；P = 0.026] 和门静脉直径 ≥ 15 mm（RR 3.636，95% CI 1.466-9.021；P = 0.005）分别是术后第 7 天和第 30 天发生 TMIP 的重要独立危险因素。结论 门静脉直径 ≥ 13 mm 和 ≥ 15 mm 分别是乙型肝炎肝硬化患者 LSD 后 TMIP 的显着独立预测因子和 POD 7 和 POD 30 的 PH。试用注册 我们在 https://www.注册了我们的研究。临床试验政府/。注册的研究名称是“华法林预防腹腔镜脾切除术和奇静脉门静脉断开后患者的门静脉血栓形成”。clinicaltrials.gov 上的试验注册标识符是 NCT02247414。