A case of endovascular treatment for acute portal vein thrombosis following portal vein resection and hepatectomy for hilar cholangiocarcinoma

Currently, portal vein (PV) resection is performed in 10%-40% of liver resections performed for hilar cholangiocarcinoma (HC). The defect is generally repaired with a patch of an autologous vein graft or end-to-end anastomosis after complete separation of the main PV trunk and the left PV. Postoperative PV thrombosis is a severe complication occurring in 2%-9% of patients requiring PV reconstruction. Here in, we presented a 55-year-old man with abdominal pain without hyperbilirubinaemia who was diagnosed with HC. The patient underwent right hepatectomy, extrahepatic biliary resection, and PV resection. The PV defect was repaired with autologous umbilical vein graft. Following the operation, acute PV thrombosis was encountered postoperative day 1. We conducted the treatment of the early acute PV thrombosis by intraportal tPA and PV stenting with endovascular approach.