Venous Thromboembolism after Surgery for Chronic Pancreatitis: Is Extended Postoperative Chemoprophylaxis Warranted?

Authors

Andrew J Thyen, Katelyn F Flick, Eugene P Ceppa, Ryan J Ellis, Michael G House, Alexandra M Roch, Cary J Schlick, C Max Schmidt, Nicholas J Zyromski, Thomas K Maatman

Published in

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. Pages 102521. Aug 17, 2026. Epub Aug 17, 2026.

Abstract

Surgery for pancreatic cancer is associated with postoperative venous thromboembolism (VTE) rates of 5-20%, prompting routine use of extended VTE chemoprophylaxis. The incidence and predictors of VTE after CP surgery are unclear.
Retrospective single institution analysis of post-surgical patients for CP between 1/2007-6/2025. Postoperative VTE rates at 90-days were evaluated, including extremity deep vein thrombosis (DVT), pulmonary embolism (PE), and mesenteric vein thrombosis (MVT). Perioperative definitions aligned with the NSQIP and ISGPS.
739 patients underwent surgery for CP. Venous thrombosis developed in 50 patients (6.8%). Postoperative DVT/PE was diagnosed in 22 patients (3.0%) on postoperative day 23±20. Multivariable regression found higher BMI, lower serum albumin, and longer operative time to be risk factors for DVT/PE. Major morbidity was higher in patients that developed DVT/PE (86.3% vs. 40.2%, p <0.001); however, mortality was similar between groups (0% vs. 0.6%, p = 0.7). Postoperative MVT was diagnosed in 33 patients (4.5%) on postoperative day 23±18. Multivariable regression found organ space infection and post-pancreatectomy hemorrhage to be risk factors for MVT. Major morbidity (81.8% vs. 39.7%, p <0.001) and mortality (6.1% vs. 0.4%, p = 0.0001) were higher in patients that developed MVT.
Extremity deep vein thrombosis, pulmonary embolism, and/or mesenteric vein thrombosis occurred in 6.8% of patients that underwent surgery for chronic pancreatitis and impact postoperative morbidity and mortality. Given this high-risk population, prospective studies optimizing strategies for postoperative chemoprophylaxis are warranted and should consider extended chemoprophylaxis and weight-based dosing.

PMID:
42607747
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.

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