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Outcomes following pancreatic surgery using three different thromboprophylaxis regimens

British Journal of Surgery Feb 23, 2019

Hanna-Sawires RG, et al. - In view of the seriousness of the complications like postpancreatectomy hemorrhage (PPH) and venous thromboembolism (VTE) following pancreatic surgery, researchers sought the timing, occurrence and predictors of PPH and VTE. Assessing elective pancreatic resections undertaken in a single university hospital between November 2013 and September 2017, they reviewed three intervals, each with a different routine regimen of nadroparin: 2850 units once daily (single dose) administered in hospital only, or 5700 units once daily (double dose) or 2850 units twice daily (split dose) administered in hospital and continued for 6 weeks after surgery. Outcomes revealed a twofold higher rate of clinically relevant PPH (CR-PPH) in correlation with a double dose of low molecular weight heparin (LMWH) prophylaxis continued for 6 weeks after pancreatic resection, that resulted in four times more relaparotomies. Higher rate of VTE was not observed among patients who received a single daily dose of LMWH in hospital only.
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