Pre- Vs. Postoperative Thromboprophylaxis in Pancreatic Surgery

Launched by HELSINKI UNIVERSITY CENTRAL HOSPITAL · Feb 8, 2022

Keywords

ClinConnect Summary

This clinical trial is exploring the best timing for starting a treatment called thromboprophylaxis, which helps prevent blood clots, in patients undergoing pancreatic surgery. There are two approaches being compared: starting the treatment before the surgery (preoperative) or after the surgery (postoperative). This is important because pancreatic surgery carries risks of both blood clots and bleeding, and doctors currently do not have a clear, agreed-upon guideline on when to start this treatment. The study aims to find out which approach is more effective and safer for patients.

To participate in this trial, patients must be between 18 and 75 years old and be scheduled for specific types of pancreatic surgeries—either a pancreaticoduodenectomy, total pancreatectomy, or a distal pancreatectomy due to suspected cancer. However, patients who have taken blood-thinning medications in the month before surgery, those needing emergency surgery, or those with certain allergies or health conditions cannot join. Participants will be randomly assigned to receive either preoperative or postoperative thromboprophylaxis and will be closely monitored throughout the process. This study is currently recruiting and aims to provide better guidelines for managing blood clots in pancreatic surgery patients.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • All patients undergoing either
• • 1. pancreaticoduodenectomy or total pancreatectomy (for any indication) or
• • 2. distal pancreatectomy for suspicion of cancer
• Exclusion Criteria:
• • 1. Patient on anticoagulative medication (heparin, low-molecular weight heparin, warfarin, direct oral anticoagulants) during the month (30 days) preceding surgery
• • 2. Emergency operation (e.g. for trauma, infection or pancreatitis)
• • 3. Age \< 18 years
• • 4. Allergy or other contraindication to planned low-molecular weight heparin
• • 5. Inability to give written informed consent
• • 6. Pancreatic resection not performed (removed from analyses after randomization)