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[Fibrinolytic system after laparoscopic cholecystectomy]
G Di Vita1, C Sciumè, G Lauria Lauria
1Dipartimento di Discipline Chirurgiche Anatomiche ed Oncologiche, II Divisione di Chirurgia, Scuola di Specializzazione in Chirurgia Generale, Università degli Studi, Palermo.
Minerva Chirurgica
|January 13, 2001
Summary
Laparoscopic cholecystectomy (LC) appears to mitigate the prothrombotic effects seen after open cholecystectomy (OC). This suggests LC may reduce the risk of deep-vein thrombosis and pulmonary embolism in surgical patients.
Area of Science:
- Cardiovascular Medicine
- Surgical Innovation
- Hemostasis and Thrombosis
Background:
- Deep-vein thrombosis (DVT) and pulmonary embolism (PE) are significant causes of morbidity and mortality following surgery.
- Laparoscopic surgery presents unique factors that may influence the risk of these thromboembolic events.
- Understanding the impact on the fibrinolytic system is crucial for risk assessment.
Purpose of the Study:
- To investigate potential alterations in the fibrinolytic system after cholecystectomy.
- To compare the effects of laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC) on hemostasis.
- To evaluate specific markers of coagulation and fibrinolysis.
Main Methods:
- Eighteen patients with symptomatic gallstones were divided into LC and OC groups (nine each).
- Evaluated preoperatively and at 6, 12, 24, and 48 hours post-operation: Antithrombin III (ATIII), Fibrinogen Degradation Products (FDP), tissue plasminogen activator (tPA), and Plasminogen Activator Inhibitor (PAI).
Main Results:
- ATIII levels showed no significant variations between groups.
- FDP levels significantly increased 48 hours post-OC.
- PAI levels increased significantly post-OC at multiple time points, while LC showed no significant variations. A significant difference between groups was noted at 12 hours.
Conclusions:
- Laparoscopic cholecystectomy (LC) may counteract prothrombotic effects compared to open cholecystectomy (OC).
- Early patient mobilization and the minimally invasive nature of LC likely contribute to reduced thrombotic risk.
- These findings highlight the potential benefits of LC in preventing postoperative thromboembolic complications.