Any operation on the pancreas is major surgery.
And it is often recommended that patients who take aspirin for cardiovascular diseases stop taking it ten days before their surgery—any major surgery—to reduce the risk of excessive bleeding during their pancreatic procedures.
Physician-researchers at Jefferson, however, have found that patients who continue taking aspirin through the morning of their surgery are at no greater risk of excessive bleeding than those who discontinue it before surgery. That means that they can keep taking the aspirin.
And that matters, because heart attacks and other cardiac events occur in up to eight percent of those at risk of cardiac disease right after major surgery. This translates into thousands of people per year. But aspirin, taken all the way up to the morning of surgery, could help these patients.
The results of this research “Safety of perioperative aspirin therapy in pancreatic surgery” were recently published in the journal Surgery.
“These data are compelling,” says surgeon Charles J. Yeo, MD, the Samuel D. Gross Professor of Surgery and Chair of the Department of Surgery at Jefferson. “The prior practice of instructing patients to stop their aspirin five to 10 days prior to surgery should be abandoned.”
Dr. Yeo, the study’s senior author, adds: “It is safe to perform major pancreas surgery in patients taking aspirin, and stopping aspirin may be dangerous.”
Aspirin therapy to prevent blood clots and heart attacks is common among patients being treated for pancreatic disorders because many also suffer from cardiovascular disease.
In this study, the surgical team at Jefferson has shown for the first time that continuing aspirin through the morning of surgery for patients undergoing elective pancreatic surgery does not increase bleeding.
The retrospective study examined the records of 1,017 patients who underwent pancreatic surgery, of whom 289 (28.4 percent) were kept on aspirin through the morning of surgery. The estimated blood loss during surgery was similar between the two groups as was the rate of blood transfusion during the hospitalization, and the amount of time the patients spend in the hospital after their operation.
“So, we have changed our practice for the better,” says Dr. Yeo. “We no longer instruct our patients to discontinue taking aspirin prior to these major pancreas operations.”