title: Basic hemostatic parameters in patients with long-term oral anticoagulation undergoing cholecystectomy.
abstract: BACKGROUND
  The current hemostatic data in relation to laparoscopic cholecystectomy (LC) is limited particularly for patients receiving chronic oral anticoagulant treatment. The aim of this study is to assess hemostatic alterations before, during and after LC for the patients placed on long-term oral anticoagulant treatment.
  
  
  METHODS
  A prospective, nonrandomized, controlled study was designed to compare the characteristics, hemostatic system, and postoperative complications of patients maintained on long-term anticoagulation with those who did not receive such therapy. In the period from January 2009 to December 2009, a total of 31 patients who underwent elective LC for symptomatic cholelithiasis were enrolled in the study. Sixteen of these patients were on long-term anticoagulation therapy with warfarin (OAC group). The other 15 patients did not receive anticoagulant or antiaggregant drugs and served as the control group.
  
  
  RESULTS
  Five patients (31.5%) of the OAC group had postoperative bleeding, whereas no bleeding occurred in the control group. Significant reductions in postoperative hemoglobin levels were observed in the OAC group when compared with the control group (P<.05). Although within normal ranges, international normalized ratio values and the tissue plasminogen activator activity were significantly higher, whereas factor II, VII, IX, and X levels were significantly lower in the OAC group when compared with the control group (P<.05).
  
  
  CONCLUSIONS
  Patients receiving oral anticoagulant treatment are at risk of postoperative bleeding and the basic parameters of coagulation appear unable to predict which patients undergoing anticoagulant therapy are candidates for bleeding after surgery. More sensitive methods should be developed to measure the degree of hemorrhagic risk.
authors.affiliation: Department of Gastroenterological Surgery, Turkiye Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Koc
authors.forename: Erdal Birol
authors.initials: EB
authors.lastname: Bostanci
authors.forename: Kerem
authors.initials: K
authors.lastname: Karaman
authors.forename: Metin
authors.initials: M
authors.lastname: Ercan
authors.forename: Tahsin
authors.initials: T
authors.lastname: Dalgic
authors.forename: Murat
authors.initials: M
authors.lastname: Ulas
authors.forename: Ilter
authors.initials: I
authors.lastname: Ozer
authors.forename: Yusuf Bayram
authors.initials: YB
authors.lastname: Ozogul
authors.forename: Selime
authors.initials: S
authors.lastname: Ayaz
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Haznedaroglu
authors.forename: Musa
authors.initials: M
authors.lastname: Akoglu
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage* / Q000494:pharmacology; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000925:Anticoagulants