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Updated: Mar 3, 2026
Laparoscopic Anatomical Liver Segment VII Resection with Liver Parenchymal Transection Following a Priority Approach
Published on: May 23, 2025
Safety and feasibility of liver resection with continued antiplatelet therapy using aspirin
Kazuteru Monden1, Hiroshi Sadamori1, Masayoshi Hioki1
1Department of Gastroenterological Surgery, Fukuyama City Hospital, Fukuyama, Hiroshima, Japan.
Insights
Continuing aspirin therapy during liver resection is safe and feasible. This approach does not increase bleeding risks, suggesting aspirin interruption is unnecessary for patients undergoing liver surgery.
Area of Science:
- Hepatobiliary Surgery
- Cardiovascular Disease Prevention
- Thrombosis and Hemorrhage Management
Background:
- Aspirin is crucial for secondary prevention of ischemic stroke and cardiovascular disease.
- Perioperative aspirin use may reduce thrombotic events but increase bleeding risks, especially during liver resection.
- This study investigated the safety of continuing aspirin during liver resection.
Purpose of the Study:
- To evaluate the safety and feasibility of performing liver resection while continuing aspirin therapy.
- To determine if perioperative aspirin use increases hemorrhagic complications in liver resection patients.
Main Methods:
- Retrospective analysis of 378 patients undergoing liver resection (January 2010 - January 2016).
- Patients were divided into two groups: aspirin users (n=31) and aspirin non-users (n=347).
- Comparison of intraoperative parameters, major morbidity, and postoperative hemorrhage between groups.
Main Results:
- Aspirin users were older with more comorbidities (hypertension, diabetes).
- No significant differences in intraoperative parameters were found.
- While major morbidity trended higher in aspirin users, no significant difference was observed; importantly, no postoperative hemorrhages occurred in the aspirin group.
Conclusions:
- Liver resection can be safely performed with continued aspirin therapy.
- Continuing aspirin does not elevate hemorrhagic morbidity in liver resection patients.
- Interruption of aspirin therapy is likely unnecessary for patients undergoing liver resection.
Background:
Aspirin is widely used for the secondary prevention of ischemic stroke and cardiovascular disease. Perioperative aspirin may decrease thrombotic morbidity, but may also increase hemorrhagic morbidity. In particular, liver resection carries risks of bleeding, leading to higher risks of hemorrhagic morbidity. Our institution has continued aspirin therapy perioperatively in patients undergoing liver resection. This study examined the safety and feasibility of liver resection while continuing aspirin.
Methods:
We retrospectively evaluated 378 patients who underwent liver resection between January 2010 and January 2016. Patients were grouped according to preoperative aspirin prescription: patients with aspirin therapy (aspirin users, n = 31); and patients without use of aspirin (aspirin non-users, n = 347).
Results:
Aspirin users were significantly older (P < 0.001), with a higher proportion of males (P < 0.001) and higher frequencies of hypertension (P = 0.004) and diabetes mellitus (P < 0.001). No significant differences were observed in intraoperative parameters. Although the frequency of major morbidity tended to be higher among aspirin users than among aspirin non-users, no significant difference was identified. No postoperative hemorrhage was seen among aspirin users.
Conclusions:
Liver resection can be safely performed while continuing aspirin therapy without increasing hemorrhagic morbidity. Our results suggest that interruption of aspirin therapy is unnecessary for patients undergoing liver resection.
