Incidence and treatment of splanchnic vein thrombosis in patients with acute pancreatitis: A systematic review and meta‐analysis

Autor: Fady S Anis, Dileep N. Lobo, Alfred Adiamah, Sudip Sanyal
Rok vydání: 2021
Předmět:
Zdroj: Journal of Gastroenterology and Hepatology. 37:446-454
ISSN: 1440-1746
0815-9319
DOI: 10.1111/jgh.15711
Popis: Background and aims This meta-analysis aimed to estimate the incidence of splanchnic vein thrombosis (SVT) in patients with acute pancreatitis and assess the effects of therapeutic anticoagulation. Methods Systematic searches of the Medline, Embase and Cochrane databases were undertaken to identify studies reporting the incidence and outcomes associated with SVT in patients with acute pancreatitis. The pooled incidence, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random effects model. PROSPERO database registration no. CRD 42021230912. Results Only 18 of the 238 studies identified met the inclusion criteria. Of the 943 patients who had SVT, 264 (28.0%) received anticoagulation. The pooled incidence of SVT at first presentation of acute pancreatitis was 15% (95% CI 5 to 26%), but was 17% (95% CI 14 to 20%) in all studies. Recanalization was more likely to occur in the anticoagulation-treated than in the untreated group (OR 0.45, 95% CI 0.26 to 0.78, p=0.004). There were significantly greater hemorrhagic complications (OR 2.61, 95% CI 1.30 to 5.22, p=0.007), but no increase in overall mortality (OR 1.57, 95% CI 0.83 to 2.97, p=0.17) in relation to the use of anticoagulation. The overall incidence of portal hypertension in patients was 60% (95% CI 55 to 65%). However, it was not possible to determine the incidence in each group. Conclusions The incidence of SVT in patients with acute pancreatitis is significant. Treatment with anticoagulants improved the odds of recanalization but increased the risk of hemorrhagic complications without increasing overall mortality.
Databáze: OpenAIRE
Externí odkaz: