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Early Portomesenteric Thrombosis Following Pancreaticoduodenectomy: Risk Factors, Management and Outcomes
Florian Martinet-Kosinski1, Mourad Abdallah1, Bruno Pereira2
1Department of Digestive and HPB Surgery and Liver Transplantation, Clermont-Ferrand University Hospital Estaing, Clermont-Ferrand, France.
Journal of Surgical Oncology
|May 18, 2026
Summary
Early portomesenteric thrombosis (ePMT) after pancreaticoduodenectomy (PD) is rare but deadly. Increased intraoperative blood loss and higher BMI are key risk factors for developing ePMT post-PD.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Vascular Surgery
Background:
- Early portomesenteric thrombosis (ePMT) is a severe complication after pancreaticoduodenectomy (PD).
- ePMT significantly increases postoperative morbidity and mortality rates.
- Identifying risk factors for ePMT is crucial for improving patient outcomes.
Purpose of the Study:
- To identify independent risk factors associated with early portomesenteric thrombosis (ePMT) following pancreaticoduodenectomy (PD).
Main Methods:
- Retrospective analysis of a prospective database of consecutive patients undergoing PD.
- Data collected from January 2007 to December 2019 at a tertiary center.
- Univariable and multivariable logistic regression analyses were performed.
Main Results:
- Nine out of 374 patients developed early ePMT, occurring at a median of 3.5 days post-surgery.
- ePMT was associated with significantly higher 90-day postoperative mortality (OR=7.1).
- Independent risk factors for ePMT included increased intraoperative blood loss (OR=6.61) and higher BMI (OR=4.44).
Conclusions:
- Early portomesenteric thrombosis is a rare but severe complication of PD with high mortality.
- Increased intraoperative blood loss and higher BMI are significant risk factors for ePMT.
- These factors may indicate greater intraoperative technical difficulty during PD.
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