A Propensity-Matched Analysis of the Postoperative Venous Thromboembolism Rate After Pancreatoduodenectomy Based on Operative Approach.
Publication/Presentation Date
3-1-2022
Abstract
BACKGROUND: The use of minimally invasive approaches for pancreatoduodenectomy has increased in recent years, but the risk of postoperative VTE is undefined. We aimed to compare venous thromboembolism (VTE) rates after open and minimally invasive pancreatoduodenectomy using an administrative dataset.
METHODS: Patients who underwent pancreatoduodenectomy within the National Surgical Quality Improvement Program targeted pancreatectomy database (2016-2018) were identified. VTE was compared between patients who underwent open or minimally invasive pancreatoduodenectomy directly and after propensity score matching 1:1 for demographics, comorbidities, and peri-/intra-operative factors.
RESULTS: A total of 12,227 patients underwent pancreatoduodenectomy during the study period (open: n = 11,217; minimally invasive: n = 1010). Before matching, the VTE rate was higher among patients who underwent minimally invasive pancreatoduodenectomy (5.2% vs. 3.8%, p = 0.033), and minimally invasive resection was independently associated with VTE (OR = 1.46, 95%CI = 1.09-2.06). After matching, there were 916 patients per group without differences in demographics or comorbidities. Patients who underwent minimally invasive pancreatoduodenectomy had longer median operative times (422 vs. 348 min). The VTE rate remained higher following minimally invasive pancreatoduodenectomy after matching (5.1% vs. 2.9%, p = 0.018), mainly driven by a higher DVT rate (3.9% vs. 1.7%, p = 0.005).
CONCLUSIONS: Minimally invasive pancreatoduodenectomy is associated with a higher postoperative VTE rate compared to open pancreatoduodenectomy.
Volume
26
Issue
3
First Page
623
Last Page
634
ISSN
1873-4626
Published In/Presented At
Hue, J. J., Elshami, M., Beckman, M. J., Driedger, M. R., Rothermel, L. D., Hardacre, J. M., Ammori, J. B., Winter, J. M., & Ocuin, L. M. (2022). A Propensity-Matched Analysis of the Postoperative Venous Thromboembolism Rate After Pancreatoduodenectomy Based on Operative Approach. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 26(3), 623–634. https://doi.org/10.1007/s11605-021-05191-y
Disciplines
Medicine and Health Sciences
PubMedID
34757511
Department(s)
Department of Surgery, Lehigh Valley Topper Cancer Institute
Document Type
Article
