D-dimer-based screening for early diagnosis of venous thromboembolism after hepatectomy

Purpose The aim of this study was to evaluate the clinical utility of a novel diagnostic algorithm based on serum d-dimer levels for venous thromboembolism (VTE) after hepatectomy. Methods We retrospectively analyzed 742 consecutive patients who underwent hepatectomy in our hospital from 2009 to 2019. From 2015, we routinely measured serum d-dimer level postoperatively and computed tomography was performed when d-dimer level was >= 20 mu g/mL. Results VTE was diagnosed in 26 patients and pulmonary embolism (PE) was diagnosed in 18 patients. Multivariate analysis revealed that resected liver weight >= 120 g is a significant predictor of VTE (P = 0.011). The incidence of VTE from 2015 to 2019 was greater than that from 2009 to 2014 (5.0% versus 2.1%, P = 0.044). The number of low-risk PE patients between 2015 and 2019 was significantly greater than that between 2009 and 2014 (P = 0.013). There was no in-hospital mortality of patients with PE from 2015 to 2019. Conclusion Patients who undergo hepatectomy are at high risk for VTE, especially when the resected liver weight is high. The proposed diagnostic algorithm based on serum d-dimer levels for VTE after hepatectomy can be useful for early diagnosis.

Automated summary

The study aimed to evaluate a novel diagnostic algorithm using serum d-dimer levels for VTE after hepatectomy. Retrospective analysis of 742 patients showed higher incidence of VTE from 2015 to 2019, with resected liver weight >= 120 g being a significant predictor. The proposed algorithm based on d-dimer levels could aid in early diagnosis of VTE in post-hepatectomy patients.