title: Should clopidogrel be discontinued before laparoscopic cholecystectomy?
abstract: BACKGROUND
  The perioperative management of clopidogrel remains an area of controversy.
  
  
  METHODS
  An institutional review board-approved retrospective review of patients undergoing a laparoscopic cholecystectomy while on clopidogrel from 2008 to 2012 was performed. These patients were then matched with a nonclopidogrel cohort based on American Society of Anesthesiologists score and emergent or elective surgery. Intraoperative estimated blood loss, operative time, length of stay, and 30-day morbidity were compared.
  
  
  RESULTS
  Thirty-six clopidogrel and 36 control patient records were analyzed. There were no significant differences in age, body mass index, sex, or incidence of coronary artery disease, diabetes, hyperlipidemia, and congestive heart failure. Estimated blood loss averaged 50 mL in the clopidogrel group and 47 mL in the control group (P = nonsignificant). There were no significant differences in operative time, 30-day morbidity, or length of stay between the 2 groups.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy performed on patients maintained on clopidogrel during the perioperative period did not produce an increase in blood loss, operative time, 30-day morbidity, or length of stay.
authors.affiliation: Baylor Scott & White Health, 2401 South 31st Street, Temple, TX 76508, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Anderson
authors.affiliation: Baylor Scott & White Health, 2401 South 31st Street, Temple, TX 76508, USA.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Jupiter
authors.affiliation: Baylor Scott & White Health, 2401 South 31st Street, Temple, TX 76508, USA.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Abernathy
authors.affiliation: Baylor Scott & White Health, 2401 South 31st Street, Temple, TX 76508, USA. Electronic address: RFRAZEE@sw.org.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Frazee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic; D000077144:Clopidogrel; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D061646:Operative Time; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine
keywords: Bleeding complications; Laparoscopic cholecystectomy; Perioperative clopidogrel