Coagulation activation after laparoscopic cholecystectomy in spite of thromboembolism prophylaxis.
BACKGROUND
The aim of this study was to determine whether laparoscopic cholecystectomy (LC), in spite of its minimally invasive nature, causes coagulation activation.


METHODS
Sixty-four patients undergoing LC were included prospectively. All received either dextran or low-molecular-weight heparin (LMWH). Blood samples taken the morning of the operation and the following morning were analyzed for TAT, FM, fragment 1+2, tPA, PAI-1, vWf, D-dimer, Hb, hematocrit, and APC resistance.


RESULTS
Significant increases in TAT, FM, fragment 1+2, and D-dimer were seen, whereas APC resistance, Hb, and hematocrit decreased significantly. Dextran led to a decrease in vWf and no change in tPA, whereas LMWH led to an increase in both these parameters.


CONCLUSIONS
Laparoscopic cholecystectomy causes coagulation activation. There are differences in the response between patients receiving dextran and LMWH as thromboembolism prophylaxis. Since most patients are discharged the day after the operation, there could be practical as well as theoretical advantages to using dextran.
Lindberg
F
F
Department of Surgery, Skellefteå County Hospital, SE-931 86 Skellefteå, Sweden.
Rasmussen
I
I
Siegbahn
A
A
Bergqvist
D
D
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D001777:Blood Coagulation; D017081:Cholecystectomy, Laparoscopic; D003911:Dextrans / Q000627:therapeutic use*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013923:Thromboembolism / Q000517:prevention & control*
D000925:Anticoagulants; D003911:Dextrans; D006495:Heparin, Low-Molecular-Weight