• Surgical innovation · Jun 2016

    Comparative Study

    Postpancreatectomy Hemorrhage After Pancreatic Surgery in Patients Receiving Anticoagulation or Antiplatelet Agents.

    • Kazuhito Mita, Hideto Ito, Koudai Takahashi, Masatoshi Hashimoto, Kiichi Nagayasu, Ryo Murabayashi, Hideki Asakawa, Kazuya Koizumi, Takashi Hayashi, and Keiichi Fujino.
    • New-Tokyo Hospital, Chiba, Japan k-mita01@sth-medical.co.jp.
    • Surg Innov. 2016 Jun 1; 23 (3): 284-90.

    AbstractBackground 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. © The Author(s) 2015.

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