Journal of Clinical Medicine
Anticoagulation for Splanchnic Vein Thrombosis in Moderate-Severe Acute Pancreatitis: In-Hospital Outcomes from a Prospective Cohort Study
By Lan Li, Xiaowen Mou, Qingyuan Tan and 5 others.
Abstract
Background
Splanchnic vein thrombosis (SVT) is a common complication of acute pancreatitis (AP), but the role of anticoagulation (AC) during acute hospitalization remains unclear. We aimed to evaluate the impact of in-hospital AC on SVT recanalization and bleeding risk.
Methods
We conducted a single-center prospective cohort study (2023–2026) including patients with moderate-severe AP and CT-confirmed SVT. The primary outcome was SVT recanalization at discharge; secondary outcome was in-hospital bleeding complications.
Results
Among the 258 included patients, 89 (34.5%) received AC. The median AC duration was 42 days (range 1–83). SVT recanalization did not differ between AC and non-AC groups (15.7% vs. 16.6%, p = 0.862). Bleeding risk was significantly higher with AC (27.0% vs. 9.5%, p < 0.001), driven predominantly by clinically significant hemoglobin decline (7.9% vs. 1.2%, p = 0.015), while major bleeding did not differ significantly between groups. Among the anticoagulated patients, those with recanalization had a higher rate of necrosectomy (78.6% vs. 53.3%, p = 0.080).