Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/96220
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Anticoagulation policy after venous resection with a pancreatectomy: a systematic review |
Author: | Chandrasegaram, M. Eslick, G. Lee, W. Brooke-Smith, M. Padbury, R. Worthley, C. Chen, J. Windsor, J. |
Citation: | Hepato Pancreato Biliary, 2014; 16(8):691-698 |
Publisher: | Wiley-Blackwell |
Issue Date: | 2014 |
ISSN: | 1365-182X 1477-2574 |
Statement of Responsibility: | Manju D. Chandrasegaram, Guy D. Eslick, Wayne Lee, Mark E Brooke-Smith, Rob Padbury, Christopher S Worthley, John W Chen, & John A Windsor |
Abstract: | BACKGROUND: Portal vein (PV) resection is used increasingly in pancreatic resections. There is no agreed policy regarding anticoagulation. METHODS: A systematic review was performed to compare studies with an anticoagulation policy (AC+) to no anticoagulation policy (AC-) after venous resection. RESULTS: There were eight AC+ studies (n = 266) and five AC- studies (n = 95). The AC+ studies included aspirin, clopidogrel, heparin or warfarin. Only 50% of patients in the AC+ group received anticoagulation. There were more prosthetic grafts in the AC+ group (30 versus 2, Fisher's exact P < 0.001). The overall morbidity and mortality was similar in both groups. Early PV thrombosis (EPVT) was similar in the AC+ group and the AC- group (7%, versus 3%, Fisher's exact P = 0.270) and was associated with a high mortality (8/20, 40%). When prosthetic grafts were excluded there was no difference in the incidence of EPVT between both groups (1% vs 2%, Fisher's exact test P = 0.621). CONCLUSION: There is significant heterogeneity in the use of anticoagulation after PV resection. Overall morbidity, mortality and EPVT in both groups were similar. EPVT has a high associated mortality. While we have been unable to demonstrate a benefit for anticoagulation, the incidence of EPVT is low in the absence of prosthetic grafts. |
Keywords: | Portal Vein |
Description: | This paper was presented at the Annual Scientific Congress of the Royal Australasian College of Surgeons (RACS), in May 2013, in Auckland, New Zealand and the RACS Tri-state Western Australia, South Australia and Northern Territory Annual Scientific Meeting 2013. |
Rights: | © 2013 International Hepato-Pancreato-Biliary Association |
DOI: | 10.1111/hpb.12205 |
Published version: | http://dx.doi.org/10.1111/hpb.12205 |
Appears in Collections: | Aurora harvest 3 Medicine publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.