Hepatobiliary & pancreatic diseases international : HBPD INT · 2026
Risk factors and anticoagulation therapy for splanchnic vein thrombosis and sinistral portal hypertension in acute pancreatitis: A two-center study.
СтатьяНазвание и аннотация: Перевод в очереди
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Ling Xin, Ai Yuan-Yuan, Zhang Ze-Wen, Lin Li-Hui, Liu Kai-Jun, Ding Zhen
Аннотация
BACKGROUND: Splanchnic vein thrombosis (SVT) and sinistral portal hypertension (SPH) are vascular complications that can occur following acute pancreatitis (AP), with a risk of gastrointestinal bleeding. This study aimed to identify risk factors for SVT and SPH in AP patients and evaluate the effectiveness of anticoagulation therapy for SVT and SPH.
METHODS: We enrolled 141 AP patients, 47 with SVT, 47 with SPH, and 47 as controls. Baseline characteristics, serum indicators, complications, treatments and prognoses were collected and analyzed.
RESULTS: Multivariate analysis identified elevated fibrinogen [odds ratio (OR) = 1.335, 95% confidence interval (CI): 1.050-1.697; P = 0.018] as an independent risk factor for SVT. Pancreatic pseudocyst (OR = 5.663, 95% CI: 1.739-18.437; P = 0.004) and recurrent AP (OR = 6.494, 95% CI: 1.805-23.365; P = 0.004) were independently associated with SPH. Subgroup analyses showed that the location of pseudocyst in body-tail of pancreas, as well as multiple recurrences of AP, were associated with the development of SPH. Among patients with SVT, the recanalization rate was significantly higher in those receiving anticoagulation compared to those who did not (69.0% vs. 31.3%, P = 0.015). Two SPH patients with thrombosis achieved resolution of varices after anticoagulation treatment. No bleeding events occurred in patients with anticoagulation therapy.
CONCLUSIONS: In AP patients, elevated fibrinogen is an independent risk factor for SVT. Pancreatic pseudocyst and recurrent AP are independent risk factors for SPH. Anticoagulation therapy was effective and safe for patients with SVT.
METHODS: We enrolled 141 AP patients, 47 with SVT, 47 with SPH, and 47 as controls. Baseline characteristics, serum indicators, complications, treatments and prognoses were collected and analyzed.
RESULTS: Multivariate analysis identified elevated fibrinogen [odds ratio (OR) = 1.335, 95% confidence interval (CI): 1.050-1.697; P = 0.018] as an independent risk factor for SVT. Pancreatic pseudocyst (OR = 5.663, 95% CI: 1.739-18.437; P = 0.004) and recurrent AP (OR = 6.494, 95% CI: 1.805-23.365; P = 0.004) were independently associated with SPH. Subgroup analyses showed that the location of pseudocyst in body-tail of pancreas, as well as multiple recurrences of AP, were associated with the development of SPH. Among patients with SVT, the recanalization rate was significantly higher in those receiving anticoagulation compared to those who did not (69.0% vs. 31.3%, P = 0.015). Two SPH patients with thrombosis achieved resolution of varices after anticoagulation treatment. No bleeding events occurred in patients with anticoagulation therapy.
CONCLUSIONS: In AP patients, elevated fibrinogen is an independent risk factor for SVT. Pancreatic pseudocyst and recurrent AP are independent risk factors for SPH. Anticoagulation therapy was effective and safe for patients with SVT.