Guideline for General and Gastroenterological Surgery in Patients Undergoing Antithrombotic Treatment: “Kokura Protocol 2019” with Appendix on Direct Oral Anticoagulants (DOACs)

In patients taking antithrombotic therapy ( ATT ) , we have to manage two conflicting risks of bleeding and thromboembolism perioperatively. W e have established our ow n perioperative antithrombotic management protocol for ATT-burdened patients (“Kokura Protocol”), and b ased on th is protocol, the hospital guideline for gastroenterological and general surgery in patients re c eiving ATT was made and have been used. Thereafter, in consideration of newly launched anticoagulants called direct oral anticoagulants ( DOACs ) , the guideline has been updated with appendix on DOACs. In this paper, our current updated guideline concerning perioperative ATT management during GE and general surgery will be outline d.