Disorders of hemostasis in the course and after laparoscopic cholecystectomy.
BACKGROUND
Hemostasis is a very important mechanism, whose changes can cause different complications. In the course of surgical interventions some changes in the system of coagulation happen. Laparoscopic cholecystectomy is a method of choice in the treatment of gallbladder calculosis. In the course of the procedure, parameters of hemostasis change, which stimulates a possible appearance of thromboembolic complications. The objective of our research was to reveal the changes in the system of coagulation in patients treated by laparoscopic cholecystectomy.


METHODS
Total sample involved 60 patients, divided into two groups, who were treated either by classical or laparoscopic method. Parameters of primary and secondary hemostasis were determined for the patients of both groups in Polyclinic for Transfusiology UKC Tuzla, before the operation, in the course, and 24 hours after the operation, and on the 5th day after the surgery.


RESULTS
Patients from both groups showed changes in the process of coagulation. The changes were more expressed in the group of patients treated by laparoscopic cholecystectomy. Very important result was the increased value of D-dimer measured on the 5th day after the operation in the patients operated by laparoscopic cholecystectomy, where value was 2.5 times higher in the relation to preoperative value (263.5 microg/l, so it was out of referential value). Increase of fibrinogen in both groups were an important result of this study.


CONCLUSIONS
Results of the study showed changes in the process of coagulation in both groups, and increased fibrinolytic activity of the organism after laparoscopic cholecystectomy (requires a discussion on longer and thorough prophylaxis of tromboembolism).
Custendil-Delic
Sunita
S
Polyclinic of Transfusiology, UKC Tuzla, Tuzla, Bosnia and Herzegovina. sunita.delic@gmail.com
Delic
Jasmin
J
Mott-Divkovic
Slavica
S
Petrov-Raslic
Jasmina
J
Ostrvica
Edin
E
Hukic
Fatima
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001778:Blood Coagulation Disorders / Q000097:blood / Q000209:etiology*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D013923:Thromboembolism / Q000209:etiology; D055815:Young Adult
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D005340:Fibrinogen