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Pancreatology. 2017 May - Jun;17(3):478-483. doi: 10.1016/j.pan.2017.03.009. Epub 2017 Mar 19.

Hypercoagulability after distal pancreatectomy: Just meaningless alterations?

Author information

1
Department of General, Visceral, and Transplantation Surgery, Germany. Electronic address: matthias.hassenpflug@med.uni-heidelberg.de.
2
Department of General, Visceral, and Transplantation Surgery, Germany.
3
Department of General, Visceral, and Transplantation Surgery, Germany; Division of Biostatistics, University of Heidelberg, Heidelberg, Germany.
4
Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, University of Munich, Germany.

Abstract

BACKGROUND:

Perioperative and short-term postoperative parameters are similar comparing spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (DPS). But there are no sound data evaluating the long term risk of postoperative thromboses and infectious complications after splenectomy. The present study evaluated whether the coagulation status differs in patients after SPDP and DPS, and whether that matters clinically.

METHODS:

A total of 41 patients after DP (SPDP = 20; DPS = 21) were followed up, focusing on alterations of patient coagulation and immune status. To assess kinetics of the coagulation process, qualitative tests (multiple platelet function analyzer, rotational thrombelastography) were used in addition to global coagulation tests.

RESULTS:

Coagulation tests revealed a significant enhanced tendency for blood-platelet aggregation and coagulation activation in patients after DPS compared to patients after SPDP. No septic or thromboembolic events were observed in any patient.

CONCLUSION:

Hypercoagulability in splenectomized patients persists over years. Thus, a correlation of this finding with thromboembolic events and mortality years after splenectomy should to be performed in a large cohort.

KEYWORDS:

Coagulation; Left pancreatectomy; Splenectomy; Thrombosis

PMID:
28372957
DOI:
10.1016/j.pan.2017.03.009
[Indexed for MEDLINE]

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