Comparison of patency rates and complications with or without antithrombotic therapy following portal vein stent placement after pancreatic surgery, a systematic review and meta-analysis.

ABSTRACT

BACKGROUND: Portal vein stent placement is used for portal vein stenosis. However, reports on post-pancreatic surgery cases are rare. Whether antithrombotic therapy should be administered remains controversial. In this paper, we reviewed current data to evaluate the influence of antithrombosis on stent patency after pancreatic surgery. MATERIALS AND METHODS: This systematic review and meta-analysis compared studies in which patients did or did not receive antithrombotic therapy after portal vein stent placement. We compared patency after stent placement and complication rate. RESULTS: There were 22 (n=207) studies in which patients received antithrombotic therapy and 8 (n=61) in which patients did not receive therapy. Antithrombotic agents, such as aspirin, clopidogrel, heparin, and warfarin, were used. The overall patency rates were similar between the groups (79.2% in the antithrombosis group vs. 88.0% in the non-antithrombosis group). Subgroup analyses included those for the etiology of stenosis, types of antithrombotic agents, acute or chronic stenosis, and causes of stent stenosis. None revealed a significant difference between the patency rates in the antithrombosis and non-antithrombosis groups. However, bleeding complications only occurred in patients who received antithrombotic therapy. CONCLUSION: There is no significant benefit of antithrombotic therapy after portal vein stent placement following pancreatic surgery. Antithrombotic therapy should be performed with caution because it may cause complications, such as bleeding.