Prophylaxis for venous thromboembolism after resection of hepatocellular carcinoma on cirrhosis: Is it necessary?

Marco Vivarelli, Matteo Zanello, Chiara Zanfi, Alessandro Cucchetti, Matteo Ravaioli, Massimo del Gaudio, Matteo Cescon, Augusto Lauro, Eva Montanari, Gian Luca Grazi, Antonio Daniele Pinna

Research output: Contribution to journalArticlepeer-review


AIM: To assess the safety and effectiveness of prophylaxis for venous thromboembolism (VTE) in a large population of patients with hepatocellular carcinoma (HCC) on cirrhosis. METHODS: Two hundred and twenty nine consecutive cirrhotic patients with HCC who underwent hepatic resection were retrospectively evaluated to assess whether there was any difference in the incidence of thrombotic or hemorrhagic complications between those who received and those who did not receive prophylaxis with low-molecular weight heparin. Differences and possible effects of the following parameters were investigated: age, sex, Child-Pugh and model for end-stage liver disease (MELD) score, platelet count, presence of esophageal varices, type of hepatic resection, duration of surgery, intraoperative transfusion of blood and fresh frozen plasma (FFP), body mass index, diabetes and previous cardiovascular disease. RESULTS: One hundred and fifty seven of 229 (68.5%) patients received antithromboembolic prophylaxis (group A) while the remaining 72 (31.5%) patients did not (group B). Patients in group B had higher Child-Pugh and MELD scores, lower platelet counts, a higher prevalence of esophageal varices and higher requirements for intraoperative transfusion of FFP. The incidence of VTE and postoperative hemorrhage was 0.63% and 3.18% in group A and 1.38% and 1.38% in group B, respectively; these differences were not significant. None of the variables analyzed including prophylaxis proved to be risk factors for VTE, and only the presence of esophageal varices was associated with an increased risk of bleeding. CONCLUSION: Prophylaxis is safe in cirrhotic patients without esophageal varices; the real need for prophylaxis should be better assessed.

Original languageEnglish
Pages (from-to)2146-2150
Number of pages5
JournalWorld Journal of Gastroenterology
Issue number17
Publication statusPublished - 2010


  • Hepatic surgery
  • Hepatocellular carcinoma
  • Liver cirrhosis
  • Postoperative bleeding
  • Postoperative thromboembolism
  • Venous thromboembolism prophylaxis

ASJC Scopus subject areas

  • Gastroenterology


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