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Practice patterns of VTE chemoprophylaxis after discharge following hepatic and pancreatic resections for cancer: A survey of hepatopancreatobiliary surgeons

  • Samantha M. Ruff
  • Reed I. Ayabe
  • Michael M. Wach
  • Laurence P. Diggs
  • Sean P. Martin
  • Jeremy L. Davis
  • Jonathan M. HernandezEmail author
Article
  • 11 Downloads

Abstract

Patients with hepatopancreatobiliary (HPB) malignancies undergoing resection are prone to venous thromboembolism (VTE), and current guidelines recommend up to 28 days of chemoprophylaxis after major surgery. We sought to determine the practice patterns among HPB surgeons for use of chemoprophylaxis after discharge. A survey on VTE chemoprophylaxis after oncologic HPB operations was distributed to attending surgeons at the 18 HPB fellowship training programs in the United States and Canada. Of the HPB surgeons surveyed, 44 (44%) responded. VTE prophylaxis is used by 93% of respondants in the inpatient postoperative setting. Chemoprophylaxis after discharge for pancreaticoduodenenctomy and distal pancreatectomy is utilized by 45% and 39% of respondants, respectively. Of those who prescribe chemoprophylaxis after discharge, 79% and 88% prescribe it for the recommended 28 days after pancreaticoduodenectomy and distal pancreatectomy, respectively. Chemoprophylaxis after discharge for major and minor hepatectomy is utilized by 39% and 26% of respondents, respectively. Of those who prescribe chemoprophylaxis after discharge, 67% and 55% provide it for the recommended 28 days after major and minor hepatectomy, respectively. Despite documented prolonged postoperative thrombogenic risk, the use of chemoprophylaxis following discharge after pancreatic and liver resections for cancer was moderate among surveyed HPB surgeons.

Keywords

Venous thromboembolism Surgery Survey Chemoprophylaxis Cancer 

Notes

Funding

This project was in part funded by the intramural research program at the NIH, where the authors are employed.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical approval

There were no animals used in this study. Survey results were collected from human (respondents) anonymously. This survey was approved by the Office of Human Subjects Research Protections and was determined not to need an IRB. A consent statement was included in the email that went to every respondent stating that by participating in the survey they consented to have their results included in this study.

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Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019

Authors and Affiliations

  • Samantha M. Ruff
    • 1
  • Reed I. Ayabe
    • 1
  • Michael M. Wach
    • 1
  • Laurence P. Diggs
    • 1
  • Sean P. Martin
    • 1
  • Jeremy L. Davis
    • 1
  • Jonathan M. Hernandez
    • 1
    Email author
  1. 1.National Institutes of HealthBethesdaUSA

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