Follow-up results of acute portal and splenic vein thrombosis with or without anticoagulation therapy after hepatobiliary and pancreatic surgery
- Authors
- Cho, CW[Cho, Chan Woo]; Park, YJ[Park, Yang Jin]; Kim, YW[Kim, Young-Wook]; Choi, SH[Choi, Sung Ho]; Heo, JS[Heo, Jin Seok]; Choi, DW[Choi, Dong Wook]; Kim, DI[Kim, Dong-Ik]
- Issue Date
- Apr-2015
- Publisher
- 대한외과학회
- Keywords
- Thrombosis; Mesentery; Surgery; Portal vein; Anticoagulants
- Citation
- ANNALS OF SURGICAL TREATMENT AND RESEARCH, v.88, no.4, pp.208 - 214
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- ANNALS OF SURGICAL TREATMENT AND RESEARCH
- Volume
- 88
- Number
- 4
- Start Page
- 208
- End Page
- 214
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/42766
- DOI
- 10.4174/astr.2015.88.4.208
- ISSN
- 2288-6575
- 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.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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