Laparotomy combined with mechanical thrombectomy for acute,critical,noncirrhotic portal and mesenteric vein thrombosis

Abstract

Introduction:

The study aimed to evaluate the efficacy and safety of laparotomy combined with mechanical thrombectomy in patients with acute, critical, noncirrhotic porto-mesenteric vein thrombosis (NC-PMVT).

Methods:

Between January 2018 and January 2025, 20 patients diagnosed with acute, critical NC-PMVT, who underwent laparotomy with mechanical thrombectomy, were included in this study. Baseline characteristics, clinical presentation, and perioperative data were collected. Safety and efficacy were evaluated based on symptom relief, recanalization rate, technical success, and procedure-related complications. Recurrence and long-term complications were assessed over a 12-month follow-up.

Results:

The technical success rate was 100%. Intestinal resection was performed in eight patients, with a mean resected bowel length of 61.75 ± 9.75 cm. Abdominal pain was alleviated in 60% of patients by postoperative day 5. The mean length of hospital stay was 10 ± 3.91 days. At discharge, 12 (60%) patients achieved complete recanalization (CR) and eight (40%) demonstrated partial recanalization (PR). At follow-up, CR was observed in 16 (80%) patients, PR persisted in three (15%), and one died from an unrelated condition. All surviving patients achieved complete symptom resolution. No procedure-related complications or recurrences were reported during follow-up.

Conclusion:

Laparotomy with mechanical thrombectomy is demonstrated to be a safe and effective treatment for acute, critical NC-PMVT.