Risk Factors of Venous Thromboembolism Following Radical Pancreatoduodenectomy with Different Vascular Reconstruction Mode
WANG Ming，CUI Song-ping，WANG Jing
Abstract:
Objective The purpose of this study was to analyse the clinical characteristics and risk factors of venous thromboembolism (VTE) in order to comprehensively predict the prevalence and risk factors of it in patients undergoing radical pancreatoduodenectomy. Methods Basic information, laboratory examination and pathological data of 346 consecutive patients who underwent radical pancreatoduodenectomy in Lujiang County People' s Hospital and Beijing Chaoyang Hospital from June 2017 to December 2021 were retrospectively analyzed. All patients were examined by lower limb vein ultrasonography before and after operation. VTE Group (n =45) and non-VTE group (n =305) according to whether they had new VTE after surgery, and the Patients were divided into clinicopathological date of the two group were compared, and the risk factors of postoperative VTE were analyzed by multivariate logistic regression. Results All patients completed the operation successfully,and 41 patients developed VTE after operation, with an incidence of 11.8%, the remaining 305 cases were in the non-VTE group. There were significant differences in lymphocyte count, tissue factor, D-dimer level before operation, on day 1 and day 3 after operation, and vascular reconstruction mode between the two groups. The operation time of VTE group was longer than that of no VTE group, and the difference was statistically significant (P < 0.05). The postoperative pathological results of all patients in this group were pancreatic ductal adenocarcinoma, among which 217 cases were moderately and highly differentiated and 129 cases were poorly differentiated. There was a statistically signi.cant difference in the degree of differentiation between the two groups(P < 0.05). Multivariate logistics regression analysis showed that advanced age, elevated tissue factor, elevated D-dimer (the first day after operation), all ovascular replacement and tumor differentiation were independent risk factors for VTE after lung surgery (P <0.05), meanwhile, increased lymphocyte count was the protective factor (P < 0.05). Conclusion Advanced age, elevated tissue factor, elevated D-dimer (the .rst day after operation), allovascular replacement and tumor differentiation were independent risk factors for VTE after operation, while higher lymphocyte count often meant lower VTE in patients following radical pancreatoduodenectomy.
