Colorectal liver metastasis increases the risk of pulmonary embolism after liver resection

Background: Pulmonary embolism (PE) is a recognized complication after postoperative procedures. However, in liver resection, there is scarce evidence. The aim of this study was to identify risk factors of PE in liver surgery. Patients and methods: From September 2009 until July 2015, 213 consecutive liver resections were performed at our centre. All patients received standard medical and mechanic thrombo-prophylaxis. Patients with clinical suspicion (Wells Score > 4) of PE underwent diagnosis by multi-slice CT. The contribution to the risk of PE at 90 days was analyzed by univariate analysis from demographic, clinical, biochemical and procedure-related variables. Variables achieving a P value < 0.05 were introduced into a multivariate binomial logistic regression analysis Results: Nine patients evolved with PE (4.7%). The PE group (n = 9) vs. non-PE group (n = 203) were similar in demographic, clinical, biochemical and procedure-related variables with exceptions of malignant disease (100 vs. 62%; p = 0.04), metastatic colorectal disease (89 vs. 42%; p = 0.001), arterial hypertension (78 vs. 40%; p = 0.02) and operative time>4 hours (89 vs. 55%; p = 0.047). At multivariate analysis, the only independent predictor for PE was the presence of metastatic colorectal disease (OR 6.25; 95th CI: 1.1–78, p = 0.03). The 90-day mortality was higher in PE group (22.2 vs. 3.9%; OR 7 95th CI: 1.2-39, p = 0.01). Conclusion: Patients with metastatic colorectal disease had a higher risk of PE after liver resection, increasing postoperative mortality. Our result might suggest the need of individualized thrombo-prophylaxis in this subgroup of patients.