The effect of hepatectomy on coagulation: an evaluation by thromboelastography.
OBJECTIVE
Liver has a major role in coagulation. The hemostatic derangements measured by the mostly used coagulation parameters as prothrombin time, activated partial thromboplastin time, and thrombocyte count do not always correlate with the bleeding associated with liver diseases and these factors do not measure the thrombotic risks. So, thromboelastography is used in new clinical and laboratory research. The aim of this study is to study the effect of different levels of hepatectomy on coagulation.


METHODS
Laparatomy, 40% hepatectomy, and 70% hepatectomy was performed in three different groups of rats. Prothrombin time, international normalized ratio, activated partial thromboplastin time, thrombocyte count, fibrinogen levels, and thromboelastography parameters were obtained at the 0, 6, and 24th hour of the study.


RESULTS
Fibrinogen level at the 24th hour was greater than the early hours in both of the hepatectomy groups. Prothrombin time and international normalized ratio values were significantly higher in hepatectomy groups than in the sham group. There were no statistically significant difference in the clotting time, clot formation time, alpha-angle, and maximum clot firmness values in any of the thromboelastography channels, in any of the study times, in between the sham, 40% hepatectomy, and 70% hepatectomy groups.


CONCLUSIONS
There is no difference between 40 and 70% hepatectomy when the coagulopathy is evaluated. The coagulation derangements as reflected by the increase in fibrinogen and prolongation of prothrombin time and activated partial thromboplastin time after hepatectomy were not supported by thromboelastography parameters in this study.
Department of General Surgery, Hacettepe University Medical School, Ankara, Turkey. Derykarakoc@yahoo.com
Derya
D
Karakoc
Erhan
E
Hamaloglu
Arif
A
Ozdemir
Ahmet
A
Dogrul
Ahmet
A
Ozenc
D000818:Animals; D001778:Blood Coagulation Disorders / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D005340:Fibrinogen / Q000378:metabolism; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods; D019934:International Normalized Ratio; D008297:Male; D010314:Partial Thromboplastin Time; D011517:Prothrombin Time; D051381:Rats; D017208:Rats, Wistar; D013916:Thrombelastography
D005340:Fibrinogen