Successful Treatment Of Postoperative Pulmonary Embolism:a Case Series Report

Background:Postoperative pulmonary embolism (POPE) is a complication with high mortality. The purpose of this paper is to present a case series of POPE in a heptopancreatobiliary (HPB) surgery specialized center and the experience of successful management as well.Methods:Between Jan2012and Jan2015, patients who underwent hepatopancreatobiliary surgery in the Department of Hepatobiliary&Pancreatic Surgery, the Second Affiliated Hospital, the School of Medicine, Zhejiang University were reviewed. Demorgraphics, clinical manifestation, management of the series of seven consecutive patients with POPE were collected and analyzed respectively.Results:The overall incidence of POPE in our department was0.19%. Of the7patients with POPE, six patients were perfomed hepatic procedure and1patient underwent pancreatectomy, diagnosed on the median postoperative day6(1to19) with median Caprini score9(4to10). Every patient had the typical symptom as dyspnea and only1patient accompanied with hypotension shock. The diagnosis was based on computed tomographic pulmonary angiography (CTPA) reconstruction. The median interval between the onset of dyspnea and diagnosis was0days (0to6). All of the seven patients with POPE were successfully treated with anticoagulant therapy. No recurrence and obvious chronic pulmonary arterial hypertension in an over-3-month follow-up.Conclusion:POPE is a severe complication after HPB surgery. The incidence of POPE in hepatic surgery is higher than in pancreatic surgery. Well awareness, early diagnosis and timely appropriate management are the key points of successful treatment for POPE.