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Anticoagulant treatment of portal thrombosis associated with cirrhosis: a real challenge! Volume 30, issue 5, Septembre-Octobre 2021

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Authors
Service d’hépato-gastro-entérologie, CHU Hassan II de Fès, Maroc
Faculté de médecine et de pharmacie, université Sidi Mohamed ben Abdallah de Fès, Maroc
* Tirés à part

Portal thrombosis (PT) is a very common complication during cirrhosis. Several studies have looked at the impact of anticoagulation. The purpose of this study is to determine the clinical impact of anticoagulants in cirrhotic patients’ cancer-free. Patients and Methods: This is a descriptive and analytical retrospective study involving all cirrhotic patients who developed PT between January 2009 and July 2018. Anticoagulant therapy was indicated for symptomatic thrombosis or identification of a thrombotic condition. Results: 364 Cirrhotic were collected, including 73 patients (20%) who developed PT. The average age was 52 years with an F/H ratio of 1.43. PT was discovered on ultrasound in 78 % of cases while it was discovered as a result of abdominal pain or complications of HTP in 14 % and 8 % of cases respectively. Cirrhosis was ranked according to the Child-Pugh A, B and C score in 29 %, 56% and 15% of cases respectively. A thrombotic condition was identified in 37 % of cases (n-27). Anticoagulant therapy was initiated in 31 patients (42.46%). The average decline was 26 months [18-108]. Full permeabilization rates at 6, 12 months and at 24 months 15.7 %, 45% and 63% respectively with a significant improvement in Child's score of at least 2 points (p<0.0001). Compared to treated patients, there was more progression in PT (35.9% vs. 3.4%, p-0.004), liver decompensation (83% vs. 20.6%, p<0.0001) and mortality (23.8% vs. 6.6%, p-0.006). Conclusion: The results of our study confirm the value of anticoagulant therapy to improve morbi-mortality during cirrhosis.