title: The efficacy of laparoscopic cholecystectomy without discontinuation in patients on antithrombotic therapy.
abstract: OBJECTIVE
  Laparoscopic cholecystectomy (LC) is one of the most commonly performed surgeries in the world today. However, there is no consensus regarding whether LC can be performed in patients with acute cholecystitis while on antithrombotic therapy. The objective of our study was to describe postoperative outcomes of patients who underwent emergent LC without interruption to antithrombotic therapy.
  
  
  METHODS
  We performed a retrospective review of patients who underwent LC for acute cholecystitis while on antithrombotic therapy from 2010 to 2015 at Soonchunhyang Universtiy Cheonan Hospital. Patients were divided into 2 groups as underwent emergent LC and elective LC.
  
  
  RESULTS
  A total of 67 patients (emergent group, 22; elective group, 45) were included in the analysis. Elective group had significantly longer duration between the admission and operation (8 [7-10] daysvs. 2 [1-3] days, P < 0.001) and longer duration of antithrombotic drugs discontinuation (7 daysvs. 1 [0-3] days, P < 0.001). Emergent group had significantly more postoperative anemia (6 patientsvs. 0 patient, P = 0.001) and 3 of 6 patients received packed RBC transfusion in postoperative period. However, there was no significant difference in length of postoperative stays, length of intensive care unit stays and mortality rates.
  
  
  CONCLUSIONS
  Emergent LC without interruption to antithrombotic therapy was relatively safe and useful. A well-designed multicenter study is needed to confirm the safety and efficacy of LC without suspension of antithrombotic therapy and to provide a simple guideline.
authors.affiliation: Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Jong Hyuk
authors.initials: JH
authors.lastname: Yun
authors.affiliation: Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Hae Il
authors.initials: HI
authors.lastname: Jung
authors.affiliation: Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Hyoung Uk
authors.initials: HU
authors.lastname: Lee
authors.affiliation: Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Moo-Jun
authors.initials: MJ
authors.lastname: Baek
authors.affiliation: Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Bae
keywords: Acute cholecystitis; Antithrombotic therapy; Laparoscopic cholecystectomy