[The importance of forseeing and early diagnosis of thromboembolic disease].
The aim of this study is to assess the incidence of thromboembolism in laparoscopic cholecystectomies. 100 unselected patients undergoing laparoscopic procedures performed by the same team were studied. All patients received preoperative prophylaxis with low/molecular weight heparin (LMWH), which was continued until full mobility. Four cases of deep venous thrombosis of lower limbs were clinically identified and confirmed by means of Doppler ultrasound examination. There were no cases of pulmonary embolus. Deep venous thrombosis occurred during the prophylactic administration of LMWH in the fourth postoperative day, consequently intravenous treatment with Heparin and then with oral anticoagulants was required. In each observation the operation took more than one hour. Among the patient-dependent risk factors, we have identified: age above 40 years, obesity, history of deep venous thrombosis, localized preoperative infection, congestive cardiac failure. Although the thromboprophylaxis has been performed within the laparoscopic surgery similar to that recommended in the classical procedures, when a high risk has developed the illness started. We underline the importance of a careful postoperative clinical monitoring in order to prevent the serious accidents that may appear.
Palade
R
R
Clinica Chirurgie I, Spitalul Universitar de Urgenţă Bucureşti.
Năstăsescu
T
T
Voiculescu
D
D
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D042241:Early Diagnosis; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D012307:Risk Factors; D013924:Thrombophlebitis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; C094240:reviparin