title: Changes in coagulation and fibrinolysis during laparoscopic cholecystectomy.
abstract: 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.
authors.affiliation: Second Propedeutical Department of Surgery, Aristotle University Medical School, Hippocration Hospital, Thessaloniki, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Marakis
authors.forename: Theodoros E
authors.initials: TE
authors.lastname: Pavlidis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Ballas
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Karvounaris
authors.forename: Savas
authors.initials: S
authors.lastname: Rafailidis
authors.forename: Athanasios K
authors.initials: AK
authors.lastname: Sakantamis
mesh_terms: 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
chemical_list: D001779:Blood Coagulation Factors; D000990:Antithrombin III