Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2015; 21(2): 533-540
Published online Jan 14, 2015. doi: 10.3748/wjg.v21.i2.533
Thrombomodulin in the management of acute cholangitis-induced disseminated intravascular coagulation
Keigo Suetani, Chiaki Okuse, Kazunari Nakahara, Yosuke Michikawa, Yohei Noguchi, Midori Suzuki, Ryo Morita, Nozomi Sato, Masaki Kato, Fumio Itoh
Keigo Suetani, Chiaki Okuse, Kazunari Nakahara, Yosuke Michikawa, Yohei Noguchi, Midori Suzuki, Ryo Morita, Nozomi Sato, Masaki Kato, Fumio Itoh, Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki 216-8511, Japan
Author contributions: Suetani K, Okuse C and Nakahara K designed the report; Suetani K, Nakahara K, Michikawa Y, Noguchi Y, Suzuki M, Morita R, Sato N and Kato M were attending physicians for the patients in the study; Okuse C and Itoh F organized the report; Suetani K wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kazunari Nakahara, PhD, Department of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki 216-8511, Japan. nakahara@marianna-u.ac.jp
Telephone: +81-44-9778111 Fax: +81-44-9765805
Received: April 26, 2014
Peer-review started: April 27, 2014
First decision: May 13, 2014
Revised: June 8, 2014
Accepted: July 11, 2014
Article in press: July 11, 2014
Published online: January 14, 2015
Processing time: 266 Days and 17 Hours
Core Tip

Core tip: To evaluate the need for thrombomodulin (rTM) in the management of acute cholangitis (AC)-induced disseminated intravascular coagulation (DIC), we retrospectively compared patients treated with rTM (rTM group) and without rTM (control group). DIC resolution rates were higher in the rTM group (P < 0.01). Multivariate analysis identified only the absence of biliary drainage as significantly associated with persistent DIC (P < 0.01), while there was a trend towards an association between persistent DIC and a lack of rTM (P = 0.08). Therefore, the add-on effects of rTM are anticipated in the treatment of AC-induced DIC, although biliary drainage remains crucial.