Impact of preoperative aspirin continuation on bleeding complications during or after liver resection: Propensity score-matched analysis.

Abstract

There is insufficient evidence concerning the effect of preoperative continuation of antiplatelet therapy (APT) on intraoperative and postoperative bleeding during liver resection. This study investigated the efficacy and safety of preoperative aspirin continuation on bleeding complications during or after liver resection using propensity score matching (PSM). Between 2005 and 2018, 425 patients who underwent liver resection were enrolled in this study. Patients were divided into two groups; the cAPT group received continued aspirin monotherapy preoperatively (n=63) and the control group did not (n=362). Propensity score matching was performed based on the preoperative clinical parameters. Intraoperative and postoperative complications, including bleeding complications, were compared between groups. After propensity score matching, 126 patients were included in the analysis (cAPT group, n=63 and control group, n=63). There were no differences in patients' background characteristics, and intraoperative blood loss was identical between the groups (200 vs 180mL, P=.54). The frequency of postoperative complications (Clavien-Dindo class 2 or higher, 13/63 [20.6%] vs 13/63 [20.6%], P=1.00) and postoperative hemorrhagic complication (3/63 [4.8%] vs 3/63 [4.8%], P=1.00) was also similar between the groups; no difference was observed in the length of postoperative stay (11days vs 14days, P=.08). Preoperative continuation of aspirin monotherapy does not affect intraoperative or postoperative bleeding in patients receiving liver resection. Either open or laparoscopic liver resection can be safely performed in patients with continued aspirin therapy.