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Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo
Published on: August 4, 2018
Thromboelastographic changes in liver and pancreatic cancer surgery: hypercoagulability, hypocoagulability or
Lesley De Pietri1, Roberto Montalti, Bruno Begliomini
1Division of Anaesthesiology, Azienda Ospedaliero-Universitaria di Modena-Policlinico, Modena, Italy. lesley.depietri@yahoo.it
European Journal of Anaesthesiology
|April 15, 2010
Summary
Perioperative coagulative alterations after oncologic surgery are hard to predict. Thromboelastography (TEG) offers a better assessment of coagulation changes than routine tests, especially after pancreas surgery.
Area of Science:
- Surgical Oncology
- Hematology
- Anesthesiology
Background:
- Perioperative hypercoagulability is clinically evident but difficult to predict using standard tests.
- Oncologic surgeries, particularly liver and pancreas resections, pose risks of bleeding and coagulation disturbances.
- Assessing haemostasis alterations is crucial for patient safety and management.
Purpose of the Study:
- To evaluate the entity, extent, and duration of perioperative coagulative alterations.
- To compare routine coagulation tests with thromboelastography (TEG) in liver and pancreas oncologic surgery.
- To identify discrepancies in assessing hypercoagulability and hypocoagulability.
Main Methods:
- Fifty-six patients undergoing liver (n=38) or pancreas (n=18) oncologic surgery were studied.
- Coagulation profiles were assessed using platelet count, PT-INR, aPTT, ATIII, and TEG.
- Measurements were taken pre-incision, end-operation, and on postoperative days 1, 3, 5, and 10.
Main Results:
- Preoperative coagulation and TEG were normal.
- Postoperatively, routine tests showed increased PT-INR, reduced ATIII and platelets, while TEG indicated normocoagulability in liver resections and transient hypocoagulability in pancreas resections.
- Four pulmonary embolism cases occurred without laboratory or TEG evidence of hypercoagulability.
Conclusions:
- TEG revealed normocoagulability in liver resections and transient hypocoagulability in pancreas resections, contrasting with routine lab results.
- Discrepancies between lab values and TEG were more pronounced in major liver resections.
- TEG is a valuable tool for evaluating perioperative coagulation and hypercoagulability, enhancing patient safety and antithrombotic therapy management.
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