Improvement of Hypoalbuminemia and Hepatic Reserve after Stent Placement for Postsurgical Portal Vein Stenosis

Abstract

Purpose: To investigate the change in serum albumin (Alb) levels and hepatic reserve scores before and after portal vein stent placement (PVS) for postsurgical portal vein (PV) stenosis.

Materials and methods: A retrospective cohort of patients who underwent PVS after abdominal surgery between 2007 and 2021 was analyzed. Patients' age, sex, and PVS technical success (defined by PV patency at final portography) were evaluated. Alb, prothrombin time-international ratio (PT-INR), total bilirubin (Tbili), platelet (Plt) counts, Child-Pugh scores (CPS), and Alb-bilirubin (ALBI) scores/grades before and 1 month after PVS were compared. Normally distributed variables were summarized as mean ± standard deviation (SD) and compared with paired t-tests. Skewed variables were summarized as median (interquartile range) and compared with the signed-rank tests.

Results: Twenty-five patients (mean age, 61 years [SD ± 10]; female, 44%) were included. Technical success of PVS was achieved in all. Comparison was conducted for 28 PVS sessions: the Alb levels increased from 3.1 g/dL (SD ± 0.6) to 3.5 g/dL (SD ± 0.5) (P = .006), with greatest change in patients with pre-PVS Alb levels of ≤2.9 g/dL (2.6 g/dL ± 0.3 to 3.3 g/dL ± 0.4, P < .001). Improvements in CPS (P = .026), ALBI score (P = .002), and ALBI grades (P = .026) were observed. PT-INR elongated (1.2 [1.1-1.3] to 1.3 [1.2-1.6], P = .002), mainly because of patients receiving post-PVS warfarin (P = .005 and P = .20 for with and without warfarin, respectively). No significant changes were observed for Tbili (P = .40) and Plt counts (P = .25).

Conclusions: Improvements of liver synthetic function represented by serum Alb levels and in hepatic reserve scores were observed after PVS, particularly in patients with pre-PVS hypoalbuminemia.