Use of aspirin and bleeding‐related complications after hepatic resection. BJS 2018; 105: 429-438.
Published: 7th February 2018
Authors: M. Gelli, M. A. Allard, O. Farges, C. Paugam‐Burtz, J. Y. Mabrut, J. M. Regimbeau et al.
The operative risk of hepatectomy under antiplatelet therapy is unknown. This study sought to assess the outcomes of elective hepatectomy performed with or without aspirin continuation in a well balanced matched cohort.
Data were retrieved from a multicentre prospective observational study. Aspirin and control groups were compared by non‐standardized methods and by propensity score (PS) matching analysis. The main outcome was severe (Dindo–Clavien grade IIIa or more) haemorrhage. Other outcomes analysed were intraoperative transfusion, overall haemorrhage, major morbidity, comprehensive complication index (CCI) score, thromboembolic complications, ischaemic complications and mortality.
Before matching, there were 118 patients in the aspirin group and 1685 in the control group. ASA fitness grade, cardiovascular disease, previous history of angina pectoris, angioplasty, diabetes, use of vitamin K antagonists, cirrhosis and type of hepatectomy were significantly different between the groups. After PS matching, 108 patients were included in each group. There were no statistically significant differences between the aspirin and control groups in severe haemorrhage (6·5
This observational study suggested that aspirin continuation is not associated with a higher rate of bleeding‐related complications after elective hepatic surgery.Full text
You may also be interested in
Neoadjuvant chemotherapy response influences outcomes in non‐colorectal, non‐neuroendocrine liver metastases.
Authors: A. M. Lucchese, A. N. Kalil, A. Ruiz, V. Karam, O. Ciacio, G. Pittau et al.
Notes: Multimodal therapy works
Authors: B. Groot Koerkamp, W. R. Jarnagin
Development and validation of a difficulty score to predict intraoperative complications during laparoscopic liver resection. BJS 2018; 105: 1182-1191.
Authors: M. C. Halls, G. Berardi, F. Cipriani, L. Barkhatov, P. Lainas, S. Harris et al.
Notes: Helps improve selection for laparoscopic liver resection
Validation of at least 1 mm as cut‐off for resection margins for pancreatic adenocarcinoma of the body and tail. BJS 2018; 105: 1171-1181.
Authors: T. Hank, U. Hinz, I. Tarantino, J. Kaiser, W. Niesen, F. Bergmann et al.
Notes: Validated for R0
Meta‐analysis comparing upfront surgery with neoadjuvant treatment in patients with resectable or borderline resectable pancreatic cancer. BJS 2018; 105: 946-958.
Authors: E. Versteijne, J. A. Vogel, M. G. Besselink, O. R. C. Busch, J. W. Wilmink, J. G. Daams et al.
Notes: Improved survival with neoadjuvant treatment
Genetic And Morphological Evaluation (GAME) score for patients with colorectal liver metastases. BJS 2018; 105: 1210-1220.
Authors: G. A. Margonis, K. Sasaki, S. Gholami, Y. Kim, N. Andreatos, N. Rezaee et al.
Notes: Predicts survival
Reappraisal of classification of distal cholangiocarcinoma based on tumour depth. BJS 2018; 105: 867-875.
Authors: H. Aoyama, T. Ebata, M. Hattori, M. Takano, H. Yamamoto, M. Inoue et al.
Notes: Better for T staging
Prediction of major complications after hepatectomy using liver stiffness values determined by magnetic resonance elastography. BJS 2018; 105: 1192-1199.
Authors: N. Sato, A. Kenjo, T. Kimura, R. Okada, T. Ishigame, Y. Kofunato et al.
Notes: liver stiffness predicts complications
Prognostic impact of perihepatic lymph node metastases in patients with resectable colorectal liver metastases. BJS 2018; 105: 1200-1209.
Authors: M. Okuno, C. Goumard, T. Mizuno, S. Kopetz, K. Omichi, C.‐W. D. Tzeng et al.
Notes: Bad sign of advanced disease
Randomized clinical trial
Randomized clinical trial of the effect of a fibrin sealant patch on pancreatic fistula formation after pancreatoduodenectomy. BJS 2018; 105: 811-819.
Authors: M. Schindl, R. Függer, P. Götzinger, F. Längle, M. Zitt, S. Stättner et al.
Notes: Not effective in reducing complications
Trends in use of lymphadenectomy in surgery with curative intent for intrahepatic cholangiocarcinoma. BJS 2018; 105: 857-866.
Authors: X.‐F. Zhang, J. Chakedis, F. Bagante, Q. Chen, E. W. Beal, Y. Lv et al.
Notes: Lymphadenectomy is important
Meta‐analysis of an artery‐first approach versus standard pancreatoduodenectomy on perioperative outcomes and survival. BJS 2018; 105: 628-636.
Authors: N. Ironside, S. G. Barreto, B. Loveday, S. V. Shrikhande, J. A. Windsor, S. Pandanaboyana et al.
Notes: Benefits to artery‐first approach