Safety of liver resection in patients receiving antithrombotic therapy: A systematic review of the literature

Table 2 Reported data concerning bleeding complications of liver resection in patients with antithrombotic therapy

Ref.	Year, type	Surgery type	Drug use and exposure	Bleeding events	TE, mortality
Naito et al[9]	2020, PSM	Liver resection (n = 425)	Patients with continued ASA (n = 63); Patients not on continued APT (control, n = 362); Post-PSM: 63 vs 63 matched cases	BC 4.8% in continued ASA vs 4.8% in control (P = 1.00); SBL was identical (P = 0.54)	TE 1.6% in continued ASA vs 4.8% in control (P = 0.62); Mortality 1.6% vs 1.6% (P = 1.00)
Fujikawa et al[10]	2017, RCS	Liver resection (n = 258) including 77 laparoscopic liver resection	Patients with ATT (n = 100); Patients without ATT (control; n = 158)	BC 3.0% in ATT vs 3.8% in control (P > 0.05); No BC in laparoscopic surgery; SBL was identical	TE 1.0% vs 1.3% (P > 0.05); No TE in laparoscopic surgery; Mortality 1.0% vs 0% (P = 0.350)
Ishida et al[11]	2017, CCS	HBP surgery (n = 886) including 520 liver resection	Patients with ACT (n = 39); Patients with APT (n = 77); Patients without ATT (control, n = 770)	BC 0.0% in ACT vs 1.3% in APT vs 3.4% in control (P = 0.32); SBL was identical (P = 0.99)	TE 0% vs 1.3% vs 0.8% (P = 0.75); Mortality 0% vs 0% vs 1.2% (P = 0.50)
Gelli et al[12]	2018, PSM	Liver resection (n = 1803)	Patients with continued ASA (n = 118); Patients not on continued APT (control, n = 1685); Post-PSM: 108 vs 108 matched cases	Overall BC 10.2% in continued ASA vs 12.0% in control (P > 0.05); Major BC 6.5% vs 5.6% (P > 0.05)	Mortality 5.6% vs 4.6% (P > 0.05)
Monden et al[13]	2017, CCS	Liver resection (n = 378)	Patients with continued ASA (n = 31); Patients not on continued APT (control, n = 347)	Major BC 0% in continued ASA vs 0.3% in control (P > 0.05); SBL 450 mL vs 360 mL (P = 0.735)	TE 3.2% vs 0% (P > 0.05); Mortality 3.2% vs 0.9% (P = 0.291)
Fujikawa et al[14]	2019, CCS	HBP surgery (n = 105) including 37 liver resection	Patients with DOAC (n = 35); Patients with WF (control, n = 80)	BC 2.9% in DOAC vs 0% in WF (P = 0.304); SBL was identical (P = 0.782)	No TE event in both groups; No mortality in both groups

RCS: Retrospective cohort study; mRCS: Multicenter retrospective cohort study; CCS: Case-control study; PSM: Case-control study with propencity-score matching; ATT: Antithrombotic therapy; APT: Antiplatelet therapy; ACT: Anticoagulation therapy; ASA: Aspirin; LAP: Laparoscopic; SBL: Surgical blood loss; BC: Postoperative bleeding complication; TE: Thromboembolism.