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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Anticoagulation for Splanchnic Vein Thrombosis in Moderate-Severe Acute Pancreatitis: In-Hospital Outcomes from a Prospective Cohort Study

  • Lan Li1
  • Xiaowen Mou1
  • Qingyuan Tan1
  • Yun Ma2
  • Lihui Deng1
  • Ziqi Lin1
  • Tao Jin1
  • Qing Xia1
  1. 1West China Center of Excellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
  2. 2West China Biobank, West China Hospital, Sichuan University, Chengdu 610041, China
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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). Conclusions: In this observational cohort, in-hospital AC was not associated with improved short-term SVT recanalization but was associated with a higher incidence of bleeding complications, driven predominantly by clinically significant hemoglobin decline. These observations require confirmation in randomized trials.

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Cite

BibTeXRIS
BibTeX
@article{li2026anticoagulation,
  title = {{Anticoagulation for Splanchnic Vein Thrombosis in Moderate-Severe Acute Pancreatitis: In-Hospital Outcomes from a Prospective Cohort Study}},
  author = {Lan Li and Xiaowen Mou and Qingyuan Tan and Yun Ma and Lihui Deng and Ziqi Lin and Tao Jin and Qing Xia},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15207824},
  url = {https://www.mdpi.com/2077-0383/15/20/7824},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Anticoagulation for Splanchnic Vein Thrombosis in Moderate-Severe Acute Pancreatitis: In-Hospital Outcomes from a Prospective Cohort Study
AU  - Lan Li
AU  - Xiaowen Mou
AU  - Qingyuan Tan
AU  - Yun Ma
AU  - Lihui Deng
AU  - Ziqi Lin
AU  - Tao Jin
AU  - Qing Xia
PY  - 2026
DA  - 2026/10/10
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15207824
UR  - https://www.mdpi.com/2077-0383/15/20/7824
AB  - 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). Conclusions: In this observational cohort, in-hospital AC was not associated with improved short-term SVT recanalization but was associated with a higher incidence of bleeding complications, driven predominantly by clinically significant hemoglobin decline. These observations require confirmation in randomized trials.
SN  - 2077-0383
ER  -