title: Venous thromboembolism after laparoscopic cholecystectomy: clinical burden and prevention.
abstract: BACKGROUND
  The clinical benefit of prophylaxis for venous thromboembolism (VTE) in laparoscopic cholecystectomy is unclear. This study aimed to assess the clinical burden of VTE and the efficacy and safety of antithrombotic prophylaxis during laparoscopic cholecystectomy.
  
  
  METHODS
  Data sources and study selection studies were searched in MEDLINE and Embase using the terms "cholecystectomy and venous thrombosis" and "cholecystectomy and venous thromboembolism." Studies were considered for a systematic review and a metaanalysis if they reported on the methods of antithrombotic prophylaxis and on the incidence of objectively confirmed VTE in patients who had undergone laparoscopic cholecystectomy. Overall, 15 studies of patients who had undergone laparoscopic cholecystectomy were included in the systematic review.
  
  
  RESULTS
  The incidence of VTE was lower after laparoscopic cholecystectomy than after open cholecystectomy [odds ratio (OR), 0.47; 95 % confidence interval (CI), 0.40-0.56]. No statistically significant reduction in VTE was observed in patients receiving heparin prophylaxis after laparoscopic cholecystectomy (OR, 0.86; 95 % CI, 0.12-5.82).
  
  
  CONCLUSIONS
  The rate of VTE after laparoscopic cholecystectomy seems to be relatively low. The clinical benefit of heparin prophylaxis for patients undergoing laparoscopic cholecystectomy remains unclear.
authors: Departement of Surgery, University of Perugia, Perugia, Italy. rondellif@hotmail.com
authors: Fabio
authors: F
authors: Rondelli
authors: Giorgia
authors: G
authors: Manina
authors: Giancarlo
authors: G
authors: Agnelli
authors: Cecilia
authors: C
authors: Becattini
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D019106:Postoperative Hemorrhage / Q000139:chemically induced; D011379:Prognosis; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*
chemical_list: D005343:Fibrinolytic Agents
references: Surg Endosc. 2000 Sep;14(9):858-61
references: 11000369
references: Surg Endosc. 1998 Jan;12(1):7-11
references: 9419295
references: Arch Surg. 1998 Sep;133(9):967-73
references: 9749849
references: Surg Endosc. 1995 Mar;9(3):304-9
references: 7597604
references: J Thromb Haemost. 2010 Jan;8(1):202-4
references: 19878532
references: JAMA. 2000 Apr 19;283(15):2008-12
references: 10789670
references: Surg Laparosc Endosc Percutan Tech. 1999 Apr;9(2):135-9
references: 11757541
references: Chirurg. 1997 Dec;68(12):1275-80
references: 9483355
references: Thromb Res. 1997 May 1;86(3):271-3
references: 9175248
references: BMJ. 2003 Sep 6;327(7414):557-60
references: 12958120
references: J Natl Cancer Inst. 1959 Apr;22(4):719-48
references: 13655060
references: Control Clin Trials. 1986 Sep;7(3):177-88
references: 3802833
references: Chest. 2012 Feb;141(2 Suppl):e227S-e277S
references: 22315263
references: Med J Aust. 1996 Jun 3;164(11):652-4, 656
references: 8657026
references: JSLS. 2000 Oct-Dec;4(4):291-5
references: 11051187
references: Ann Surg. 2007 Dec;246(6):1021-7
references: 18043105
references: BMJ. 1993 Feb 20;306(6876):518-9
references: 8448483
references: Curr Opin Pulm Med. 2003 Sep;9(5):356-61
references: 12904703
references: Surg Endosc. 2002 Jan;16(1):184-7
references: 11961636
references: Surg Endosc. 2007 Sep;21(9):1588-92
references: 17332962
references: BMJ. 2001 Jul 14;323(7304):101-5
references: 11451790
references: J Thromb Haemost. 2005 Feb;3(2):216-20
references: 15670021
references: Int J Surg. 2009 Apr;7(2):130-5
references: 19144583