title: Hypercoagulability after distal pancreatectomy: Just meaningless alterations?
abstract: BACKGROUND
  Perioperative and short-term postoperative parameters are similar comparing spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (DPS). But there are no sound data evaluating the long term risk of postoperative thromboses and infectious complications after splenectomy. The present study evaluated whether the coagulation status differs in patients after SPDP and DPS, and whether that matters clinically.
  
  
  METHODS
  A total of 41 patients after DP (SPDP = 20; DPS = 21) were followed up, focusing on alterations of patient coagulation and immune status. To assess kinetics of the coagulation process, qualitative tests (multiple platelet function analyzer, rotational thrombelastography) were used in addition to global coagulation tests.
  
  
  RESULTS
  Coagulation tests revealed a significant enhanced tendency for blood-platelet aggregation and coagulation activation in patients after DPS compared to patients after SPDP. No septic or thromboembolic events were observed in any patient.
  
  
  CONCLUSIONS
  Hypercoagulability in splenectomized patients persists over years. Thus, a correlation of this finding with thromboembolic events and mortality years after splenectomy should to be performed in a large cohort.
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Germany. Electronic address: matthias.hassenpflug@med.uni-heidelberg.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hassenpflug
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Germany.
authors.forename: Christin
authors.initials: C
authors.lastname: Tjaden
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Germany; Division of Biostatistics, University of Heidelberg, Heidelberg, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Hinz
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Germany.
authors.forename: Johanna
authors.initials: J
authors.lastname: Volpert
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Germany.
authors.forename: Thilo
authors.initials: T
authors.lastname: Hackert
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Germany.
authors.forename: Markus W
authors.initials: MW
authors.lastname: Büchler
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, University of Munich, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Werner
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects*; D010974:Platelet Aggregation; D011183:Postoperative Complications / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control; D018570:Risk Assessment; D013156:Splenectomy; D013530:Surgical Wound Infection / Q000517:prevention & control; D013923:Thromboembolism / Q000209:etiology; D019851:Thrombophilia / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology*; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D014057:Tomography, X-Ray Computed; D014914:Whole Blood Coagulation Time; D055815:Young Adult
keywords: Coagulation; Left pancreatectomy; Splenectomy; Thrombosis