Inhibitor development in mild haemophilia after a major surgery for periampullary cancer (Whipple’s procedure) in an elderly man

Ganju, Neha; Rajendran, Jayapal; Aggarwal, Mukul; Dash, Nihar Ranjan

doi:10.1136/bcr-2020-239207

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…However, because of the bleeding tendency of hemophiliac patients, physicians might hesitate to perform surgical resection of the liver or even ultrasound‐guided radio frequency ablation (RFA), 10 despite those treatments being indicated. In addition, as these hemophilic patients age, not only hepatic malignancies but also bile duct cancers and pancreatic cancers are developing and requiring surgery if possible 11 . Although some case reports have been published in the abdominal surgical area, no systematic reports have been found in the updated literature 12‐15 …”

Section: Discussionmentioning

confidence: 99%

“…In addition, as these hemophilic patients age, not only hepatic malignancies but also bile duct cancers and pancreatic cancers are developing and requiring surgery if possible. 11 Although some case reports have been published in the abdominal surgical area, no systematic reports have been found in the updated literature. [12][13][14][15] The group of one of the authors reported the results of hepatectomy in hemophilia patients in 2018.…”

Section: Discussionmentioning

confidence: 99%

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National survey of hepatobiliary and pancreatic surgery in hemophilia patients in Japan

Yoshimoto-Haramura

Hidaka

Hasegawa

et al. 2021

J Hepato Biliary Pancreat

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Background Approximately 8300 hemophiliacs are registered in Japan, but no comprehensive reports on hepatobiliary and pancreatic surgery (HBPS) have been conducted. This report investigates the current status of HPBS in hemophilia patients in Japan. Methods The subjects were hemophiliac patients seen between January 1 2007, and December 31 2017, at facilities participating in this study among the facilities for performing high‐difficulty cases nationwide designated by the Japanese Society for HBPS. A retrospective examination of short‐term outcomes in 49 cases was conducted to assess patient background, disease, surgical procedure, and complications. Results The types of hemophilia were A: 43 cases, B: four cases, and von Willebrand disease: two cases (hemophilia severity: mild 32, moderate seven, severe 10). The target malignant diseases for surgery were hepatocellular carcinoma (HCC) in 20 cases, intrahepatic cholangiocellular carcinoma (CCC) in four cases, combined HCC‐CCC in two cases, hilar CCC in two cases, and pancreatic cancer in four cases. As for the surgical procedure, limited resection (subsegmentectomy and partial hepatectomy) was performed in 16 cases of HCC even with normal liver function tests. Pancreaticoduodenectomy and distal pacreatectomy were performed for pancreatic cancers as in the standard procedure. Postoperative complications were postoperative bleeding in two cases after hepatectomy and one after pancreatectomy in one case. When compared with Japanese National Clinical Data base, the complication rates after hepatectomy and pancreatectomy were not conspicuous in hemophilic patients. Conclusions As long as they are performed in qualified centers, complication rate is not increased in hemophilic patients undergoing HBPS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

National survey of hepatobiliary and pancreatic surgery in hemophilia patients in Japan

Yoshimoto-Haramura

Hidaka

Hasegawa

et al. 2021

J Hepato Biliary Pancreat

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Mortality in Haemophilia Patients in India: A National Cohort Study

Shetty,

Ross,

John

et al. 2024

Haemophilia

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IntroductionMortality and morbidity in persons with haemophilia (PWH) have decreased due to improved diagnosis and treatment along with comprehensive population outreach efforts, but the impact is not uniform in different countries.AimThe study aims to assess all‐cause and intracranial haemorrhage (ICH)‐specific mortality of PWH in India.MethodsThis is a retrospective, observational, multi‐centric cohort study of 1020 haemophilia patients from three centres in India. The mortality data in the family was collected from personal interviews, and subsequently confirmed with the corresponding haemophilia treatment centres (HTCs). The demographic and clinical data, along with other comorbidities, were collected from the medical records.ResultsAmong 170 reported deaths, 73 (42.9%) were caused by ICH, and 44 (25.9%) resulted from accidents or trauma. Gastrointestinal (GI) bleeding was the third most common cause of death, accounting for 27 cases (15.9%). The average and median ages at death were 27.7 and 26 years, respectively. None of the deceased cases were receiving any prophylactic or immune tolerance induction (ITI) therapy, and all had severe haemophilia. In addition, the prevalence of inhibitors and hypertension was significantly higher in deceased cases compared to that in the general haemophilia population (p < 0.05).ConclusionSeverity of haemophilia, episodic treatment, hypertension and inhibitors showed significant association with mortality. ICH continues to be the leading cause of death among haemophilia patients in the country. This underscores the challenges in managing haemophilia and the need for improved treatment strategies to increase the life expectancy of PWH.

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Inhibitor development in mild haemophilia after a major surgery for periampullary cancer (Whipple’s procedure) in an elderly man

Cited by 2 publications

References 11 publications

National survey of hepatobiliary and pancreatic surgery in hemophilia patients in Japan

National survey of hepatobiliary and pancreatic surgery in hemophilia patients in Japan

Mortality in Haemophilia Patients in India: A National Cohort Study

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