Portal vein thrombosis in liver cancer

This is an automatically translated article.

The article was professionally consulted with Doctor Tran Quoc Tuan - Emergency Resuscitation Doctor - Emergency Resuscitation Department - Vinmec Phu Quoc International General Hospital.

1. What is portal vein thrombosis?

The portal vein is the vein that takes blood from internal organs including: stomach, spleen, pancreas, large intestine, small intestine, ... and then leads to the liver, so it is called the hepatic portal vein.
Portal vein thrombosis is the embolism of one or more branches of the portal vein due to thrombosis. Portal vein thrombosis is divided into acute or chronic depending on the course of the disease.
The acute stage has unclear manifestations such as: Abdominal bloating, abdominal pain, loss of appetite, nausea, weight loss and diarrhea,... The chronic phase may appear due to rupture of esophageal varices. or other manifestations of portal hypertension including: splenomegaly, ascites, or collateral circulation.

2. Portal vein thrombosis in liver cancer

Portal vein thrombosis in liver cancer is end-stage disease, often with a poor prognosis.
Types of portal vein thrombosis in liver cancer may include:
Right or left portal vein thrombosis Segmental branch portal vein thrombosis Smaller venous thrombosis Main body portal vein: Due to thrombosis The left or right portal vein extends into and causes complete occlusion of the main body.

3. Causes of portal vein thrombosis

The most common cause of portal vein thrombosis in liver cancer is hepatocellular carcinoma. The liver is an organ rich in blood vessels, so the portal vein is easily invaded and metastasized into the portal vein. On the other hand, this is also a major factor leading to liver cancer.
Subjects prone to portal vein thrombosis are those with related diseases such as liver cancer, cirrhosis, pancreatitis, blood clotting disorders,... Or people with hepatic portal vein occlusion, due to genetics. People who regularly use alcohol, tobacco, etc. are also prone to portal vein thrombosis.

4. Treatment of portal vein thrombosis in liver cancer

There are many treatment methods for portal vein thrombosis in liver cancer including:
4.1 Take the portal vein thrombosis Portal vein thrombosis in liver cancer if not treated in time will tend to cause occlusion of the lumen. Eventually, it will turn into portal vein fibrosis. A thrombectomy may be performed to remove a thrombus in cases of acute and localized venous thrombosis. This method needs to be performed by a gastroenterologist and vascular surgeon.
Indicated for acute cases, localized thrombosis in the main trunk or the first extrahepatic branch: the right and left branches.
Contraindicated in the following cases:
Chronic portal vein thrombosis Thrombosis spreading into the superior mesenteric veins, splenic veins, intrahepatic branches. End stage liver cancer, distant metastasis, peritoneal metastasis. There are serious medical diseases such as: Respiratory, cardiovascular, blood clotting disorders, ...

4.2 Resection of the portal vein and anastomosis with an artificial vessel After clamping the upper and lower ends of the portal vein, resect the portal vein with invasive tumor. After that, the two ends of the vein with the length and diameter of the artificial vessel are connected together. The portal vein section and the artificial vessel connection are indicated in the case of pancreatic tumors, cholangiocarcinomas with venous invasion. Portal vein
Contraindicated for:
Tumor with distant metastasis, peritoneal metastasis Having serious medical diseases: Respiratory, cardiovascular, coagulation disorders,... 4.3 Embolism of radiation therapy Embolism of radiation therapy Also known as selective radiation therapy, is a method applied in liver cancer with portal vein thrombosis. If left untreated, the patient's survival is very low. Currently, experts still agree on contraindications to surgery in this case.
Radiation embolization is a modern technique, opening up new opportunities for liver cancer patients with portal vein thrombosis. Radioisotope is injected directly into the tumor through the artery to focus the radiation dose locally, limiting damage to the surrounding healthy liver parenchyma. This method is evaluated to have many outstanding advantages compared to the previous method of trans-arterial embolization.
However, embolization radiotherapy is a new method that requires the coordination of 4 main specialties: Nuclear medicine, gastroenterology, interventional cardiology and diagnostic imaging. In addition, it is also necessary to combine doctors of other specialties such as oncology and surgery with modern techniques and equipment and large treatment costs.

5. How to prevent portal vein thrombosis in liver cancer

To prevent portal vein thrombosis in liver cancer, patients need to:
A reasonable, healthy diet, and limit stimulants Create a habit of regular exercise and sports. Comfort People with related diseases such as: Blood clotting disorders, pancreatitis, pancreatic tumors, venous obstruction,... need to regularly visit and monitor the disease In short, portal vein thrombosis is a condition. common in liver cancer. There is strong evidence that portal vein thrombosis is associated with the development of metastases and an increased risk of early recurrence after treatment. Therefore, when you see any abnormal signs, it is necessary to notify the doctor immediately for timely intervention.
The danger of liver cancer has shown the importance of screening and early detection of the disease. Therefore, Vinmec International General Hospital has provided customers with a package of screening and early detection of liver cancer to screen for liver cancer for people at high risk of diseases such as: alcoholics, cirrhosis, family history of liver cancer, cirrhosis, hepatitis B virus infection, chronic hepatitis C,...
Service selection Package for screening and early detection of liver cancer, patients will be examined, consulted and performed tests, diagnostic imaging to evaluate liver function, liver diseases and liver cancer screening. With a system of modern machinery and a team of highly qualified and experienced doctors, Vinmec is committed to the best protection for the health of patients.

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