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Randomized controlled trials of low molecular weight heparin in non-mild acute pancreatitis: A systemic review and meta-analysis

  • Author Footnotes
    1 These authors contributed equally to this work.
    Kun He
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Yuelun Zhang
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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  • Kai Song
    Affiliations
    Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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  • Zhengyang Fan
    Affiliations
    Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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  • Liang Gong
    Affiliations
    Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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  • Huijun Shu
    Correspondence
    Correspondence to: H. Shu, Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Beijing 100730, China.
    Affiliations
    Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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  • Dong Wu
    Correspondence
    Correspondence to: D. Wu, Clinical Epidemiology Unit, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing 100730, China.
    Affiliations
    Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China

    Clinical Epidemiology Unit, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
Published:November 17, 2022DOI:https://doi.org/10.1016/j.thromres.2022.11.012
      Acute pancreatitis (AP) is a common disease with substantial morbidity and mortality, and its incidence has grown in recent years. Mild AP has a self-limited course and only needs supportive treatment while non-mild AP referring to moderately severe and severe AP (MSAP and SAP) is associated with local and systemic complications, notably pancreatic necrosis and organ failure, claiming the poor prognosis. MSAP is defined as AP having local complications with or without transient organ failure (<48 h) while SAP is characterized by persistent organ failure (>48 h). Non-mild AP can be complicated with vascular thrombosis (e.g. splanchnic vein thrombosis, thrombosis of portal vein and superior mesenteric vein), which shows poor effect on the ultimate prognosis [
      • Boxhoorn L.
      • Voermans R.P.
      • Bouwense S.A.
      • Bruno M.J.
      • Verdonk R.C.
      • Boermeester M.A.
      • van Santvoort H.C.
      • Besselink M.G.
      Acute pancreatitis.
      ]. Conventional therapy includes early fluid resuscitation, analgesics, enteral nutrition, and symptomatic treatment. Up to now, there is a lack of effective pharmacological treatments for AP. However, in the recent decade, there were several randomized controlled trials (RCTs) about the effects of low molecular weight heparin (LMWH) therapy in non-mild AP, of which the results were inconsistent.

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