Portal Venous System Thrombosis After Pancreatic Resection
(2013) In World Journal of Surgery 37(1). p.179-184- Abstract
- Portal venous system thrombosis (PVST) is a rare, potentially fatal complication after pancreatic resection. The aim of this study was to assess the incidence, presenting symptoms, management, and treatment of PVST in a large cohort of patients. Prospectively collected data on patients undergoing pancreatic resection between 1997 and 2009 were reviewed retrospectively. Preoperative and postoperative imaging were analyzed for the presence or absence of venous thrombi. All patients received standard thromboprophylaxis with low-molecular-weight heparin (LMWH). Of 516 pancreatic resections performed, 18 (3.5 %) were complicated by PVST. The most common clinical presentations were abdominal pain (n = 9) and ascites (n = 5) but never any alarm... (More)
- Portal venous system thrombosis (PVST) is a rare, potentially fatal complication after pancreatic resection. The aim of this study was to assess the incidence, presenting symptoms, management, and treatment of PVST in a large cohort of patients. Prospectively collected data on patients undergoing pancreatic resection between 1997 and 2009 were reviewed retrospectively. Preoperative and postoperative imaging were analyzed for the presence or absence of venous thrombi. All patients received standard thromboprophylaxis with low-molecular-weight heparin (LMWH). Of 516 pancreatic resections performed, 18 (3.5 %) were complicated by PVST. The most common clinical presentations were abdominal pain (n = 9) and ascites (n = 5) but never any alarm symptoms. Other symptoms were vague and nonspecific (e.g., weight loss, fatigue, fever). Total pancreatectomy was a risk factor compared to hemipancreatectomy (p < 0.01), whereas the underlying disease per se did not make any difference. The median interval between surgery and diagnosis of PVST was 105 days (range 1-1,440 days). PVST was at least a contributing factor in the postoperative deaths of two patients. LMWH therapy did not significantly affect survival. PVST remains a relatively infrequent complication after pancreatic resection. Because accurate diagnosis and timely intervention may reduce morbidity and mortality, the possibility of PVST should be considered in patients presenting with vague symptoms. Whether anticoagulant treatment is needed is still not clear; there were no obvious differences in outcome between treated and untreated patients. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3481514
- author
- Ansari, David ; Ansorge, Christoph ; Andren-Sandberg, Ake ; Ansari, Daniel LU and Segersvard, Ralf
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- in
- World Journal of Surgery
- volume
- 37
- issue
- 1
- pages
- 179 - 184
- publisher
- Springer
- external identifiers
-
- wos:000312808400025
- scopus:84871758855
- pmid:22965537
- ISSN
- 1432-2323
- DOI
- 10.1007/s00268-012-1777-8
- language
- English
- LU publication?
- yes
- id
- c4c55b02-5a8a-4ba9-aaaa-97ec65908f62 (old id 3481514)
- date added to LUP
- 2016-04-01 13:34:26
- date last changed
- 2022-03-29 08:09:38
@article{c4c55b02-5a8a-4ba9-aaaa-97ec65908f62,
abstract = {{Portal venous system thrombosis (PVST) is a rare, potentially fatal complication after pancreatic resection. The aim of this study was to assess the incidence, presenting symptoms, management, and treatment of PVST in a large cohort of patients. Prospectively collected data on patients undergoing pancreatic resection between 1997 and 2009 were reviewed retrospectively. Preoperative and postoperative imaging were analyzed for the presence or absence of venous thrombi. All patients received standard thromboprophylaxis with low-molecular-weight heparin (LMWH). Of 516 pancreatic resections performed, 18 (3.5 %) were complicated by PVST. The most common clinical presentations were abdominal pain (n = 9) and ascites (n = 5) but never any alarm symptoms. Other symptoms were vague and nonspecific (e.g., weight loss, fatigue, fever). Total pancreatectomy was a risk factor compared to hemipancreatectomy (p < 0.01), whereas the underlying disease per se did not make any difference. The median interval between surgery and diagnosis of PVST was 105 days (range 1-1,440 days). PVST was at least a contributing factor in the postoperative deaths of two patients. LMWH therapy did not significantly affect survival. PVST remains a relatively infrequent complication after pancreatic resection. Because accurate diagnosis and timely intervention may reduce morbidity and mortality, the possibility of PVST should be considered in patients presenting with vague symptoms. Whether anticoagulant treatment is needed is still not clear; there were no obvious differences in outcome between treated and untreated patients.}},
author = {{Ansari, David and Ansorge, Christoph and Andren-Sandberg, Ake and Ansari, Daniel and Segersvard, Ralf}},
issn = {{1432-2323}},
language = {{eng}},
number = {{1}},
pages = {{179--184}},
publisher = {{Springer}},
series = {{World Journal of Surgery}},
title = {{Portal Venous System Thrombosis After Pancreatic Resection}},
url = {{http://dx.doi.org/10.1007/s00268-012-1777-8}},
doi = {{10.1007/s00268-012-1777-8}},
volume = {{37}},
year = {{2013}},
}