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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 9/2011

01-09-2011 | Original Article

Post-Operative Pharmacologic Thromboprophylaxis after Major Hepatectomy

Does Peripheral Venous Thromboembolism Prevention Outweigh Bleeding Risks?

Authors: Srinevas K. Reddy, Ryan S. Turley, Andrew S. Barbas, Jennifer L. Steel, Allan Tsung, J. Wallis Marsh, Bryan M. Clary, David A. Geller

Published in: Journal of Gastrointestinal Surgery | Issue 9/2011

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Abstract

Background

Although standard of care after most abdominal surgeries, post-operative pharmacologic thromboprophylaxis after major hepatectomy is commonly withheld due to bleeding risks. The objective of this retrospective study is to evaluate the benefits and risks of post-operative pharmacologic thromboprophylaxis after major hepatectomy at two high volume academic centers.

Methods

Demographics, clinicopathologic data, treatments, and post-operative outcomes from patients who underwent major hepatectomy were reviewed.

Results

From 2005 to 2010, 419 patients underwent major hepatectomy; 275 (65.6%) were treated with pharmacologicthromboprophylaxis beginning a median of 1 day after resection. Post-operative symptomatic venous thromboembolism (VTE) occurred in 15 (3.6%) patients. Patients treated with pharmacologic thromboprophylaxis had lower rates of symptomatic VTE (2.2% vs. 6.3%, p = 0.03) and post-operative red blood cell (RBC) transfusion (16.7% vs. 26.4%, p = 0.02) with similar rates of overall RBC transfusion (35.0% vs. 30.6%, p = 0.36) compared to untreated patients. Specifically, isolated deep venous thrombosis (0% vs. 2.1%, p = 0.04) and pulmonary embolism (2.2% vs. 4.2%, p = 0.35) occurred less often in treated patients. Analysis of demographics, clinicopathologic data, and treatment factors revealed that pharmacologic thromboprophylaxis was the only variable associated with post-operative VTE.

Conclusions

Post-operative pharmacologic thromboprophylaxis lowers the incidence of symptomatic VTE after major hepatectomy without increasing the rate of RBC transfusion.
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Metadata
Title
Post-Operative Pharmacologic Thromboprophylaxis after Major Hepatectomy
Does Peripheral Venous Thromboembolism Prevention Outweigh Bleeding Risks?
Authors
Srinevas K. Reddy
Ryan S. Turley
Andrew S. Barbas
Jennifer L. Steel
Allan Tsung
J. Wallis Marsh
Bryan M. Clary
David A. Geller
Publication date
01-09-2011
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 9/2011
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-011-1591-x

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