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DOI: 10.1055/s-0041-1733591
Binational study on prevention of portal vein thromboses after portal vein resections in pancreatic surgery
Background With increasing numbers of patients being operated with borderline resectable pancreatic cancers, portal vein resections (PVR) need to be performed more commonly. The incidence of portal vein thrombosis (PVT) after PVR and the postoperative anticoagulation management, however, is unclear due to a lack of data. Thus, the present study examines the incidence, risk factors and prevention of PVT after PVR.
Methods Data on all patients with PVR and pancreatic surgery of any kind between 01/2014 and 12/2017 from two major pancreatic centers was gathered in a retrospective setting. Subsequently, patient data was analyzed for the incidence of PVT, operative and non-operative risk factors, as well as thromboprophylaxis.
Results Of 132 patients with PVR, 7,5% (n=10) had PVT postoperatively. Median time to PVT was 32 days. Neither the type of PVR nor any other of the investigated risk factors was associated with PVT. Furthermore, PVT was not associated with a change in mortality. With respect to thromboprophylaxis, therapeutic dosing or thromboprophylaxis for more than 4 weeks postoperatively had no effect on the incidence of PVT.
Conclusion Postoperative thromboprophylaxis beyond standard dosing and duration is not supported by these data. PVR during pancreatic surgery can be done safely with a low risk of PVT-associated mortality.
Publication History
Article published online:
07 September 2021
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