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Updated: Jul 9, 2025

Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
How to manage hemostasis in patients with liver disease during interventions
1King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS.
Abstract:
Patients with advanced chronic liver disease (CLD) often need procedures to both treat and prevent complications of portal hypertension such as ascites or gastrointestinal bleeding. Abnormal results for hemostatic tests, such as prolonged prothrombin time, international normalized ratio, and/or thrombocytopenia, are commonly encountered, raising concerns about increased bleeding risk and leading to transfusion to attempt to correct prior to interventions. However hemostatic markers are poor predictors of bleeding risk in CLD, and routine correction, particularly with fresh frozen plasma and routine platelet transfusions, should be avoided. This narrative review discusses the hemostatic management of patients with CLD using 2 case descriptions.
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