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- W2894912128 abstract "Introduction: Post-Pancreatectomy Hemorrhage (PPH) and Venous Thromboembolism (VTE) are serious complications following pancreatic surgery. Thromboprophylaxis by administration of Low Molecular Weight Heparin (LMWH) is the standard of care for the prevention of VTE. However, it remains a challenge to maintain a balance between the risk of PPH and VTE. The aims of this study were to investigate the incidence, timing and predictive factors of PPH and VTE in three LMWH dosage groups: single-dose (2850IU), double-dose (5700IU) and split-dose (twice-daily 2850IU) after pancreatic surgery. Method: From November 2013 through September 2017, pancreatic resections at the Leiden University Medical Center were reviewed. PPH was classified according the International Study Group of Pancreatic Surgery. Time-to-event (clinically relevant (CR)-PPH or VTE) analysis and uni- and multivariable analysis were performed. Results: In total, 240 patients were included. CR-PPH developed in 25.0%, 12.5%, and 13.8% of patients in the double-dose, single-dose, and the split dose-group respectively (P=0.069). There was no significant difference in VTE between the groups. Time-to-event (Figure 1) analysis showed 70.7% of CR-PPH and 36.4% of VTE occurred within 10 postoperative days (PODs). Lastly, patients with CR-Postoperative Pancreatic Fistula (POPF) were at higher risk for an event (HR=3.16, 95%CI=1.70-5.86, P< 0.001). Conclusions: CR-PPH appeared borderline significantly more frequently in the double dose group compared to the two other dosage groups. The incidence of VTE was not significantly different between the dosage groups. Most CR-PPH occurred within 10 PODs. Based on these results, a single dose of LMWH (2850 IU) can be considered." @default.
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- W2894912128 date "2018-09-01" @default.
- W2894912128 modified "2023-09-27" @default.
- W2894912128 title "Outcome of three different thromboprophylactic schemes after pancreatic surgery" @default.
- W2894912128 doi "https://doi.org/10.1016/j.hpb.2018.06.135" @default.
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