Low molecular weight heparin treatment of acute moderate and severe pancreatitis: A randomized, controlled,open-label study

Tozlu, Mukaddes; Kayar, Yusuf; İnce, Ali Tüzün; Baysal, Birol; Şentürk, Hakan

doi:10.5152/tjg.2018.18583

Cited by 32 publications

(30 citation statements)

References 23 publications

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“…LMWH was administered by subcutaneous injection in all included RCTs. The dosage of LMWH varied slightly among these RCTs, which was close to or equal to 5000 U every 12 h. LMWH treatment lasted for 14 days in 11 RCTs and 7 days in five RCTs . The ratio of male to female was 1.35:1 (900 males and 665 females).…”

Section: Resultsmentioning

confidence: 95%

“…Two hundred and seventeen duplicated articles and an additional 853 articles were excluded because they did not meet the selection criteria. Finally, 16 RCTs were included in the systematic review . Three RCTs were from in English, while the remaining articles were in Chinese.…”

Section: Resultsmentioning

confidence: 99%

“…Finally, 16 RCTs were included in the systematic review . Three RCTs were from in English, while the remaining articles were in Chinese. Five studies defined SAP as AP with any of the following conditions: organ failure, local complications such as abscess, pseudocyst or necrosis, Ranson score ≥ 3, APACHE II score ≥ 8, and CT grade D or E according to the Practical guidelines for the management of acute pancreatitis in China (draft) in 2004 .…”

Section: Resultsmentioning

confidence: 99%

“…Three studies defined SAP as AP with organ failure and/or local complications according to the Atlanta classification of acute pancreatitis in 1992 . One study defined SAP as AP with persistent organ failure according to the Atlanta classification of acute pancreatitis revised in 2012 . Laboratory parameters and clinical scores were assessed by the end of LMWH treatment on the 7th or 14th day after admission, and clinical outcomes were assessed before the patients were discharged from the hospital or their death.…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, LMWH combined with intensive insulin therapy could markedly shorten the intestinal recovery time and length of hospital stay, and reduce the incidence of MOF . However, Tozlu et al reported that LMWH could not significantly reduce the operation rate and mortality in SAP . Therefore, it is still debated whether LMWH is beneficial to the prognosis of SAP.…”

Section: Introductionmentioning

confidence: 99%

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The efficacy of low molecular weight heparin in severe acute pancreatitis: A systematic review and meta‐analysis of randomized controlled trials

Qiu

Tang

et al. 2019

J of Digest Diseases

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Objective The effects of low molecular weight heparin (LMWH) on severe acute pancreatitis (SAP) have been controversial. We aimed to evaluate the efficacy of LMWH on prognosis of SAP by systematic review and meta‐analysis. Methods We searched relevant studies published up to March 2019 in five databases (MEDLINE/PubMed, EMBASE, the Cochrane Central Register of Controlled Trials in Cochrane Library, China National Knowledge Infrastructure, and the Chinese Journal of Science and Technology of VIP database). Results Sixteen randomized controlled trials with 1625 patients were included in the final analysis. Most studies were from China. In analysis of laboratory parameters and clinical scores, SAP patients receiving LMWH treatment had lower white blood cell counts, C‐reactive protein level, Acute Physiology and Chronic Health Evaluation II score, and computed tomography severity index. In clinical outcomes, SAP patients who received LMWH treatment had shorter hospital stay (pooled mean difference [95% confidence interval; CI] −8.79 [−11.18, −6.40], P < .01), lower mortality (pooled risk ratio [RR] [95% CI] 0.33 [0.24‐0.44], P < .01), lower incidences of multiple organ failure (pooled RR [95% CI] 0.34 [0.23‐0.52], P < .01), pancreatic pseudocyst (pooled RR [95% CI] 0.49 [0.27‐0.90], P = .02), and operation rate (pooled RR [95% CI] 0.39 [0.31‐0.50], P < .01). Conclusions LMWH could improve the prognosis of SAP, and has a potential role in reducing hospital stay, mortality, incidences of multiple organ failure, pancreatic pseudocyst, and operation rate.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The efficacy of low molecular weight heparin in severe acute pancreatitis: A systematic review and meta‐analysis of randomized controlled trials

Qiu

Tang

et al. 2019

J of Digest Diseases

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The risk of developing splanchnic vein thrombosis in acute pancreatitis increases 3 days after symptom onset: A systematic review and meta‐analysis

Borbély,

Szalai,

Philip

et al. 2024

UEG Journal

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BackgroundSplanchnic vein thrombosis is a complication of acute pancreatitis (AP) and is likely often underdiagnosed.ObjectivesWe aimed to understand the time course and risk factors of splanchnic vein thrombosis in the early phase of AP.MethodsA systematic search was conducted using the PRISMA guidelines (PROSPERO registration CRD42022367578). Inclusion criteria were appropriate imaging techniques in adult AP patients, studies that reported splanchnic vein thrombosis data from the early phase, and reliable information on the timing of imaging in relation to the onset of pancreatitis symptoms or hospital admission. The proportion of patients with thrombosis with 95% confidence intervals (CI) was calculated using random‐effects meta‐analyses, and multiple subgroup analyses were performed.ResultsData from 1951 patients from 14 studies were analyzed. The proportion of patients with splanchnic vein thrombosis within 12 days after symptom onset was 0.13 (CI 0.07–0.23). The occurrence was lowest at 0.06 (CI 0.03–0.1) between 0 and 3 days after symptom onset, and increased fourfold to 0.23 (CI 0.16–0.31) between 3 and 11 days. On hospital admission, the proportion of patients affected was 0.12 (CI 0.02–0.49); it was 0.17 (CI 0.03–0.58) 1–5 days after admission. The prevalence in mild, moderate, and severe AP was 0.15 (CI 0.05–0.36), 0.26 (CI 0.15–0.43), and 0.27 (CI 0.17–0.4), respectively. Alcoholic etiology (0.31, CI 0.13–0.58) and pancreatic necrosis (0.55, CI 0.29–0.78, necrosis above 30%) correlated with increased SVT prevalence.ConclusionThe risk of developing splanchnic vein thrombosis is significant in the early stages of AP and may affect up to a quarter of patients. Alcoholic etiology, pancreatic necrosis, and severity may increase the prevalence of splanchnic vein thrombosis.

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Impact of low-molecular-weight heparin in the treatment of moderately severe and severe acute pancreatitis; a randomized, single blind, phase 3 control trial

Patil

Meena

Sharma

et al. 2022

International Journal of Surgery

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Low molecular weight heparin treatment of acute moderate and severe pancreatitis: A randomized, controlled,open-label study

Abstract: Serum resolvin D1 levels as a marker of inflammation in constipation dominant irritable bowel syndrome

Cited by 32 publications

References 23 publications

The efficacy of low molecular weight heparin in severe acute pancreatitis: A systematic review and meta‐analysis of randomized controlled trials

The efficacy of low molecular weight heparin in severe acute pancreatitis: A systematic review and meta‐analysis of randomized controlled trials

The risk of developing splanchnic vein thrombosis in acute pancreatitis increases 3 days after symptom onset: A systematic review and meta‐analysis

Impact of low-molecular-weight heparin in the treatment of moderately severe and severe acute pancreatitis; a randomized, single blind, phase 3 control trial

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