Asymptomatic Venous Thromboembolism After Hepatobiliary–Pancreatic Surgery: Early Detection Using D‐dimer and Soluble Fibrin Monomer Complex Levels
| Autor: | Hikaru Hayashi, Koji Kubota, Kiyotaka Hosoda, Akira Shimizu, Yuji Soejima, Tsuyoshi Notake, Ryoichiro Kobayashi, Shinsuke Sugenoya, Hitoshi Masuo, Koya Yasukawa |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
prophylactic anticoagulation RD1-811 venous thromboembolism Early detection RC799-869 Gastroenterology Asymptomatic D‐dimer Pancreatic surgery Internal medicine D-dimer medicine cardiovascular diseases Soluble Fibrin Monomer business.industry Original Articles Diseases of the digestive system. Gastroenterology equipment and supplies hepatobiliary–pancreatic surgery Surgery Original Article soluble fibrin monomer complex medicine.symptom business Venous thromboembolism |
| Zdroj: | Annals of Gastroenterological Surgery Annals of Gastroenterological Surgery, Vol 6, Iss 1, Pp 109-118 (2022) |
| ISSN: | 2475-0328 |
| Popis: | Aim The aim was to investigate the usefulness of a preemptive management strategy that includes monitoring serum D‐dimer (DD) and soluble fibrin monomer complex (SFMC) levels for early detection and treatment of venous thromboembolism (VTE) after hepatobiliary–pancreatic (HBP) surgery. Methods Overall, 678 patients who underwent HBP surgery between January 2010 and March 2020 were enrolled. Patients with increased postoperative serum DD or SFMC levels underwent contrast‐enhanced computed tomography, and those with VTE received anticoagulant agents. The VTE risk factors were investigated using multivariable analysis. Postoperative changes in DD and SFMC levels were verified, and their ability to identify VTE was evaluated using receiver operating characteristic (ROC) analysis. Results VTE developed in 83 patients (12.2%), and no symptomatic VTE or death due to VTE was observed. Multivariable analysis identified female sex (odds ratio [OR] 2.26; 95% confidence interval [CI] 1.41–3.60; P Although venous thromboembolism (VTE) is a potentially fatal postoperative event, prophylactic anticoagulation after hepatobiliary‐pancreatic (HBP) surgery remains controversial due to the risk of hemorrhage. Retrospective analyses of 678 patients who underwent HBP surgery with monitoring serum D‐dimer (DD) and soluble fibrin monomer complex (SFMC) levels without prophylactic anticoagulation therapy revealed that DD and SFMC had a good discrimination ability for the occurrence of VTE. Neither symptomatic VTE nor death due to VTE was observed. Monitoring serum DD and SFMC levels enables early detection and treatment intervention of VTE after HBP surgery. |
| Databáze: | OpenAIRE |
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