Prevention of postoperative venous thromboembolism following laparoscopic cholecystectomy.
Advantages of laparoscopic cholecystectomy are less patient discomfort and shorter hospital stay than with the traditional open approach. Nevertheless, this operation is performed under general anesthesia, using muscle relaxants and pneumoperitoneum, with most patients in the reverse Trendelenburg position. It has been shown that this procedure is associated with significant hypercoagulability and dilation of the veins of the leg. We review the role of these factors as potential risk factors for the development of postoperative venous thromboembolism and also report the rate of thromboembolic complications following laparoscopic cholecystectomy. Based on the available evidence, it is concluded that laparoscopic cholecystectomy, despite being a "minimally invasive procedure," may be associated with a definite risk of developing postoperative venous thromboembolism that could extend beyond hospital discharge. Accordingly, thrombosis prophylaxis should be considered for these patients.
Caprini
J A
JA
Department of Surgery, Glenbrook Hospital, Glenview, IL 60025.
Arcelus
J I
JI
D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D006801:Humans; D011028:Pneumoperitoneum, Artificial; D011187:Posture; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*