PMID- 27654839
OWN - NLM
STAT- MEDLINE
DCOM- 20170920
LR  - 20170920
IS  - 1421-9883 (Electronic)
IS  - 0253-4886 (Linking)
VI  - 34
IP  - 2
DP  - 2017
TI  - Hemorrhagic and Thromboembolic Complications after Hepato-Biliary-Pancreatic 
      Surgery in Patients Receiving Antithrombotic Therapy.
PG  - 114-124
LID - 10.1159/000449105 [doi]
AB  - BACKGROUND: Perioperative management for patients receiving long-term 
      anticoagulant (AC) and antiplatelet (AP) therapy is a great concern for surgeons. 
      This single-center retrospective study evaluated the risks of hemorrhage and 
      thromboembolism after hepato-biliary-pancreatic (HBP) surgery in such patients. 
      METHODS: Between 2009 and 2014, 886 patients underwent HBP surgery. Patients were 
      categorized into the AC (n = 39), AP (n = 77), or control (n = 770) group 
      according to the administration of antithrombotic drugs. Perioperative management 
      of AC and AP therapies followed the guidelines of the Japanese Circulation 
      Society. The incidences of hemorrhage and thromboembolism were compared among 
      groups. We used 1:1 propensity score matching and compared the incidences between 
      the matched pairs. RESULTS: There were 0, 1 (1.3%), and 26 (3.4%) hemorrhagic 
      complications in the AC, AP, and control groups, respectively (p = 0.16). There 
      were 0, 1 (1.3%), and 6 (0.8%) thromboembolic complications in the AC, AP, and 
      control groups, respectively (p = 0.66). There was no significant difference in 
      hemorrhagic and thromboembolic complications between the propensity-matched 
      pairs. CONCLUSION: The incidences of hemorrhage and thromboembolism after HBP 
      surgery in patients receiving long-term AC and AP therapies are within acceptable 
      ranges.
CI  - (c) 2016 S. Karger AG, Basel.
FAU - Ishida, Jun
AU  - Ishida J
AD  - Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe 
      University Graduate School of Medicine, Kobe, Japan.
FAU - Fukumoto, Takumi
AU  - Fukumoto T
FAU - Kido, Masahiro
AU  - Kido M
FAU - Matsumoto, Ippei
AU  - Matsumoto I
FAU - Ajiki, Tetsuo
AU  - Ajiki T
FAU - Kawai, Hiroya
AU  - Kawai H
FAU - Hirata, Kenichi
AU  - Hirata K
FAU - Ku, Yonson
AU  - Ku Y
LA  - eng
PT  - Journal Article
DEP - 20160922
PL  - Switzerland
TA  - Dig Surg
JT  - Digestive surgery
JID - 8501808
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/*therapeutic use
MH  - Female
MH  - Hepatectomy/adverse effects
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Pancreatectomy/adverse effects
MH  - Pancreatic Fistula/epidemiology
MH  - Pancreaticoduodenectomy/adverse effects
MH  - Perioperative Care
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Postoperative Hemorrhage/*epidemiology/etiology
MH  - Propensity Score
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Thromboembolism/*epidemiology
MH  - Young Adult
EDAT- 2016/09/23 06:00
MHDA- 2017/09/21 06:00
CRDT- 2016/09/23 06:00
PHST- 2016/03/16 00:00 [received]
PHST- 2016/08/10 00:00 [accepted]
PHST- 2016/09/23 06:00 [pubmed]
PHST- 2017/09/21 06:00 [medline]
PHST- 2016/09/23 06:00 [entrez]
AID - 000449105 [pii]
AID - 10.1159/000449105 [doi]
PST - ppublish
SO  - Dig Surg. 2017;34(2):114-124. doi: 10.1159/000449105. Epub 2016 Sep 22.