Early use of anticoagulants in patients with acute pancreatitis and association with the rate of splanchnic vein thrombosis

Abstract text (incl. references and figure legends)

Introduction

Splanchnic vein thrombosis (SVT) is a serious vascular complication that occurs in patients with complicated acute pancreatitis (AP). Our aim was to investigate the early use of low molecular weight anticoagulants (LMWA) in all patients with AP, their effectiveness on the rate of SVT and the risk of gastrointestinal bleeding (GIB).

Material and methods

We analyzed 128 patients with AP for the period of 3 years – 2018-2021 in Surgical Department of University Hospital Stara Zagora, Bulgaria. In all patients we started LMWA from the admission. We assessed the incidence of SVT and its relationship with the course of AP.

Results

In 7(5.4%) we found CT criteria for SVT. All the patients with SVT had moderate or severe disease. We detected the SVT in the period of 10th-14th day of the beginning in 4 patients and after 28th day in 3 patients. We found GIB just in one patient (0.8 %) – without SVT. In 2 patients (1.6%) the SVT was developed after laparoscopic debridement of infected necrosis. In 3 (43%) of these 7 patients we observed total thrombus resolution. Three of the patients died.

Conclusion

SVT in patients with AP is associated with complicated disease and increased mortality. LMWA are safe and may reduce the incidence of SVT in patients with AP.

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