title: Postpancreatectomy Hemorrhage After Pancreatic Surgery in Patients Receiving Anticoagulation or Antiplatelet Agents.
abstract: Background Postpancreatectomy hemorrhage (PPH) is a serious complication after pancreatic surgery. In this study, we evaluated PPH and thromboembolic complications after pancreatic surgery in patients with perioperative antithrombotic treatment. Methods Medical records of patients undergoing pancreatic surgery were reviewed retrospectively. Patients receiving thromboprophylaxis were given either bridging therapy with unfractionated heparin or continued on aspirin as perioperative antithrombotic treatment according to clinical indications and published recommendations. The International Study Group of Pancreatic Surgery definition of PPH was used. Risk factors associated with PPH were assessed by multivariate analysis. Results Thirty-four of 158 patients received perioperative antithrombotic treatment; this group had a significantly higher PPH rate (29.4% vs 6.5%, P = .001) and mortality (11.8% vs 2.4%, P = .039) than patients not receiving thromboprophylaxis. Multivariate analysis revealed that perioperative antithrombotic treatment was the only independent risk factor for PPH after pancreatic surgery (odds ratio 4.77; 95% CI 1.61-14.15; P = .005). Conclusions Perioperative antithrombotic treatment is an independent risk factor for PPH in patients undergoing pancreatic surgery, although this treatment effectively prevents postoperative thromboembolic events.
authors.affiliation: New-Tokyo Hospital, Chiba, Japan k-mita01@sth-medical.co.jp.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Mita
authors.affiliation: New-Tokyo Hospital, Chiba, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Ito
authors.affiliation: New-Tokyo Hospital, Chiba, Japan.
authors.forename: Koudai
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: New-Tokyo Hospital, Chiba, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: New-Tokyo Hospital, Chiba, Japan.
authors.forename: Kiichi
authors.initials: K
authors.lastname: Nagayasu
authors.affiliation: New-Tokyo Hospital, Chiba, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Murabayashi
authors.affiliation: New-Tokyo Hospital, Chiba, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Asakawa
authors.affiliation: New-Tokyo Hospital, Chiba, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Koizumi
authors.affiliation: New-Tokyo Hospital, Chiba, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: New-Tokyo Hospital, Chiba, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fujino
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D016022:Case-Control Studies; D016208:Databases, Factual; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000379:methods; D019990:Perioperative Care; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006493:Heparin
keywords: anticoagulation; antiplatelet; pancreatic surgery; postpancreatectomy hemorrhage; thromboprophylaxis