Anaesthetic perioperative management of patients with pancreatic cancer

Table 3 Guidelines on the prophylaxis of venous thromboembolism and antiplatelet and anticoagulant management adjusted according to recent guidelines

In patients receiving bridging anticoagulation with a therapeutic-dose IV of unfractionated heparin, treatment is recommended to be stopped no later than at 4 to 6 h prior to surgery

In patients receiving bridging anticoagulation with a therapeutic-dose of LMWH, the last preoperative dose of LMWH is recommended to be administered at approximately 24 h prior to surgery instead of at 12 h prior to surgery

In patients receiving bridging anticoagulation with a therapeutic-dose of LMWH and are undergoing high-bleeding-risk surgery, resumption of the therapeutic dose of LMWH is recommended at 48 to 72 h after surgery instead of within 24 h following surgery

In moderate-to-high-risk patients receiving acetylsalicylic acid who require non-cardiac surgery, treatment with acetylsalicylic acid is recommended to be continued around the time of surgery instead of discontinued at 7 to 10 d prior to surgery

In patients with a coronary stent who require surgery, deferment of surgery is recommended at 6 wk or 6 mo after the placement of a bare-metal or drug- eluting stent, respectively, instead of initiating surgery during these time periods

In patients requiring surgery within 6 wk or 6 mo of the placement of a bare-metal or drug-eluting stent, respectively, continuing perioperative antiplatelet therapy is recommended instead of stopping therapy at 7 to 10 d prior to surgery

Modified from Douketis et al[62]. LMWHs: Low-molecular-weight heparins.