Changes in coagulation and fibrinolysis during laparoscopic cholecystectomy.
BACKGROUND
The influence of laparoscopic cholecystectomy on coagulation and fibrinolysis is debatable. There have been a few but controversial studies and the need for routine antithrombotic prophylaxis is unclear.


METHODS
In this prospective study we investigated changes in coagulation and fibrinolysis parameters in laparoscopic cholecystectomy. Blood samples taken before, during, and after surgery from 38 consecutive patients were analyzed. Measured parameters included the international normalized ratio, prothrombin time, partial thromboplastin time, antithrombin III activity, platelet count, mean platelet volume, fibrinogen, and D-dimers.


RESULTS
Statistically significant changes included increased perioperative international normalized ratio and D-dimers, and postoperative antithrombin III, fibrinogen, and D-dimers, as well as decreased perioperative antithrombin III and fibrinogen and postoperative international normalized ratio, platelet count, and mean platelet volume. Values of partial thromboplastin time had no statistically significant changes.


CONCLUSIONS
Reduced coagulation activity and increased fibrinolytic activity occur during and after laparoscopic cholecystectomy.
Marakis
Georgios
G
Second Propedeutical Department of Surgery, Aristotle University Medical School, Hippocration Hospital, Thessaloniki, Greece.
Pavlidis
Theodoros E
TE
Ballas
Konstantinos
K
Karvounaris
Dimitrios
D
Rafailidis
Savas
S
Sakantamis
Athanasios K
AK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000990:Antithrombin III / Q000378:metabolism; D001777:Blood Coagulation / Q000502:physiology*; D001779:Blood Coagulation Factors / Q000378:metabolism; D001780:Blood Coagulation Tests; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000097:blood* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011446:Prospective Studies
D001779:Blood Coagulation Factors; D000990:Antithrombin III