Abstract：
BACKGROUND AND PURPOSE:Thromboprophylaxis is recommended for preventing postoperative venous thromboembolism (VTE) after abdominal surgery; however, its use after major hepatobiliary-pancreatic surgery is typically avoided as it increases the risk of bleeding. We conducted this study to evaluate the safety of thromboprophylaxis after major hepatobiliary-pancreatic surgery. METHODS:We analyzed the rates of postoperative bleeding, VTE, morbidity, and prolonged hospital stay in 349 patients who underwent major hepatobiliary-pancreatic surgery, such as pancreaticoduodenectomy, hemihepatectomy or greater, and hepatopancreaticoduodenectomy. RESULTS:Chemical thromboprophylaxis was associated with significantly increased rates and risks of overall bleeding events vs. no chemical thromboprophylaxis (26.6 vs. 8.5%, respectively). The rate of minor hemorrhage was significantly higher in patients who received chemical thromboprophylaxis (21.7 vs. 3.5%); however, there were no differences in the rate of major hemorrhage requiring blood transfusion or hemostatic intervention between the groups (4.8 vs. 4.9%). The postoperative VTE rate was also significantly decreased by chemical thromboprophylaxis (2.9 vs. 7.7%). However, chemical thromboprophylaxis did not affect the rate of SSI, severe morbidity, or duration of the postoperative hospital stay. CONCLUSION:We consider that chemical thromboprophylaxis is beneficial and can be safely used even after major hepatobiliary-pancreatic surgery.
journal_name
Surg Todayjournal_title
Surgery todayauthors
Hayashi H,Morikawa T,Yoshida H,Motoi F,Okada T,Nakagawa K,Mizuma M,Naitoh T,Katayose Y,Unno Mdoi
10.1007/s00595-014-0890-8subject
Has Abstractpub_date
2014-09-01 00:00:00pages
1660-8issue
9eissn
0941-1291issn
1436-2813journal_volume
44pub_type
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