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Pre- Vs. Postoperative Thromboprophylaxis in Pancreatic Surgery

RecruitingPhase 4Ages 18 Years - 120 YearsAllHelsinki University Central Hospital
NCT05245877 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

Thromboprophylaxis for pancreatic surgery can be commenced either preoperatively or postoperatively. Despite a clear trade-off between thrombosis and bleeding in pancreatic surgery patients, there is no international consensus when thrombosis prophylaxis should be commenced in patients undergoing pancreatic surgery. There are no prospective randomized trials in this field, and current guidelines are unfortunately based on very low quality evidence, that is, a few retrospective studies and expert opinion. Both American and European thromboprophylaxis guidelines for abdominal cancer surgery support the preoperative initiation of thromboprophylaxis, but these guidelines do not specifically address the increased bleeding risk associated with pancreatic surgery. On the contrary, Dutch guidelines recommend postoperative thromboprophylaxis only, because of lack of evidence for preoperative thro

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📋 Eligibility rules (as published)
Inclusion Criteria: All patients undergoing either 1. pancreaticoduodenectomy or total pancreatectomy (for any indication) or 2. distal pancreatectomy for suspicion of cancer Exclusion Criteria: 1. Patient on anticoagulative medication (heparin, low-molecular weight heparin, warfarin, direct oral anticoagulants) during the month (30 days) preceding surgery 2. Emergency operation (e.g. for trauma, infection or pancreatitis) 3. Age \< 18 years 4. Allergy or other contraindication to planned low-molecular weight heparin 5. Inability to give written informed consent 6. Pancreatic resection not performed (removed from analyses after randomization)
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What it tests

  • enoxaparin/tinzaparin/dalteparin
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Where

5 sites
Sunnybrook Health Sciences Centre
Toronto, Canada
Helsinki University Hospital
Helsinki, Finland
Oulu University Hospital
Oulu, Finland
Tampere University Hospital
Tampere, Finland
Oslo University Hospital
Oslo, Norway
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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