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Taking antithrombic therapy during emergency laparoscopic cholecystectomy for acute cholecystitis does not affect the
Kentaro Oji1, Yasunori Otowa2,3, Yuta Yamazaki1
1Department of Surgery, Kita-Harima Medical Center, 926-250 Ichiba-cho, Ono, Hyogo, 675-1392, Japan.
Insights
Continuing antithrombic therapy (ATT) during emergency surgery for acute cholecystitis (AC) does not increase bleeding risk. Controlling intraoperative bleeding is key for safe outcomes in patients undergoing emergency laparoscopic cholecystectomy (LC).
Area of Science:
- General Surgery
- Gastroenterology
- Cardiology
Background:
- Continuing antithrombic therapy (ATT) increases surgical bleeding risk.
- Discontinuing ATT is challenging in emergency surgery.
- Safety of emergency laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) with ATT is unclear.
Purpose of the Study:
- To clarify the effect of ATT during emergency LC for AC.
- To assess the safety of continuing ATT in emergency LC for AC.
Main Methods:
- Patients with AC were divided into ATT and non-ATT groups.
- Propensity score matching was used for comparison (n=22).
- Postoperative outcomes were compared between groups.
Main Results:
- ATT group showed higher c-reactive protein and shorter activated partial thromboplastin time (APTT).
- No significant differences in other patient characteristics or perioperative results.
- APTT was an independent risk factor for bleeding >100 mL (P=0.039).
Conclusions:
- Continuing ATT does not impact blood loss or complications during emergency LC for AC.
- Effective intraoperative bleeding control is crucial for safe postoperative outcomes.
Background:
Continuing antithrombic therapy (ATT) during surgery increases the risk of bleeding. However, it is difficult to discontinue the ATT in emergency surgery. Therefore, safety of emergency laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) is still unclear. We aimed to clarify the affect of ATT during emergency LC for AC.
Methods:
Patients with AC were classified into ATT group (n = 30) and non-ATT group (n = 120). Postoperative outcomes were compared after propensity score matching (n = 22).
Results:
Higher level of c-reactive protein level and shorter activated partial thromboplastin time (APTT) was observed in ATT group than in non-ATT group after matching. No significant difference was found between other patient characteristics and perioperative results. Blood loss over 100 mL was observed in 8 patients. Multivariate analyze showed that APTT was an independent risk factor for bleeding over 100 mL (P = 0.039), while ACT and APT was not.
Conclusions:
Taking ATT does not affect the blood loss or complications during emergency LC for AC. Controlling intraoperative bleeding is essential for a safe postoperative outcome.
