Follow-up results of acute portal and splenic vein thrombosis with or without anticoagulation therapy after hepatobiliary and pancreatic surgery
Annals of Surgical Treatment and Research
;
: 208-214, 2015.
Article
in English
| WPRIM
| ID: wpr-62417
ABSTRACT
PURPOSE:
Acute portal and splenic vein thrombosis (APSVT) after hepatobiliary and pancreatic (HBP) surgery is a rare but serious complication and a treatment strategy has not been well established. To assess the safety and efficacy of anticoagulation therapy for treating APSVT after HBP surgery.METHODS:
We performed a retrospective case-control study of 82 patients who were diagnosed with APSVT within 4 weeks after HBP surgery from October 2002 to November 2012 at a single institute. We assigned patients to the anticoagulation group (n = 32) or nonanticoagulation group (n = 50) and compared patient characteristics, complications, and the recanalization rate of APSVT between these two groups.RESULTS:
APSVT was diagnosed a mean of 8.6 +/- 4.8 days after HBP surgery. Patients' characteristics were not significantly different between the two groups. There were no bleeding complications related to anticoagulation therapy. The 1-year cumulative recanalization rate of anticoagulation group and nonanticoagulation group were 71.4% and 34.1%, respectively, which is statistically significant (log-rank test, P = 0.0001). In Cox regression model for multivariate analysis, independent factors associated with the recanalization rate of APSVT after HBP surgery were anticoagulation therapy (P = 0.003; hazard ration [HR], 2.364; 95% confidence interval [CI], 1.341-4.168), the absence of a vein reconstruction procedure (P = 0.027; HR, 2.557; 95% CI, 1.111-5.885), and operation type (liver resection rather than pancreatic resection; P = 0.005, HR, 2.350; 95% CI, 1.286-4.296).CONCLUSION:
Anticoagulation therapy appears to be a safe and effective treatment for patients with APSVT after HBP surgery. Further prospective studies of larger patient populations are necessary to confirm our findings.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Portal Vein
/
Splenic Vein
/
Thrombosis
/
Veins
/
Case-Control Studies
/
Multivariate Analysis
/
Retrospective Studies
/
Follow-Up Studies
/
Hemorrhage
/
Mesentery
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Annals of Surgical Treatment and Research
Year:
2015
Type:
Article
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