Perioperative medicine & outcomes
Anticoagulation Practice and Risk of Portal Vein Thrombosis Following Pancreaticoduodenectomy or Total Pancreatectomy with Venous Resection: An International Multicentre Cohort Study
Authors' conclusion
VR increases PVT risk following PD/TP, with technical factors influencing <90-day PVT and cancer-related factors influencing >90-day PVT.
Study context
- Population
- Consecutive patients undergoing pancreaticoduodenectomy (PD) or total pancreatectomy (TP) with venous resection (VR), 2018–2022 (Europe, USA, Mexico, Turkey, Australia, New Zealand)plus 1:1 matched cohort without VR
- Exposure
- PD/TP with VR vs PD/TP without VR
- VRn = 972
- Outcome
- PVT risk following PD/TP with VR, and anticoagulation practice
- Follow-up
- 30 days, 90 days and 1 year
Methodological detailsconsecutive patients, 1:1 age and sex matched comparison cohort
- Consecutive patients
- 1:1 age and sex matched comparison cohort
Main finding
As reported in the abstract
PVT risk · 30 days, 90 days, 1 year
30-day
90-day
1-year
- VR vs Without VR: P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | OR | P value |
|---|---|---|
| Postoperative therapeutic anticoagulation and PVT riskTherapeutic anticoagulation · 30-day PVT | 0.06 | P < 0.001 |
| Postoperative therapeutic anticoagulation and PVT riskTherapeutic anticoagulation · 90-day PVT | 0.06 | P = 0.075 |
| Postoperative therapeutic anticoagulation and PVT riskTherapeutic anticoagulation · >90-day PVT | 1.23 | P = 0.466 |
| Predictor of >90-day PVT: cancer recurrence · >90 daysStrongest predictor | 3.96 | P < 0.001 |
- Anticoagulation practice (VR)
- 26.6% · 259 of 972
- Anticoagulation practice (VR): 259 received inpatient therapeutic anticoagulation
Predictors of 90-day PVT
- Prior history of VTE, OR
- 2.67
- VR type 1-4, OR (P<0.001)
- 2.29, 6.28, 6.90 and 23.75
- Graft material: peritoneal, autologous vein, cadaveric vein, bovine, synthetic, OR (P<0.001)
- 0.78, 0.94, 5.28, 4.90 and 5.99
Original publication
Anticoagulation Practice and Risk of Portal Vein Thrombosis Following Pancreaticoduodenectomy or Total Pancreatectomy with Venous Resection: An International Multicentre Cohort Study. Ann Surg. Published 25 September 2025. doi:10.
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