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Postoperative hypercoagulability and deep-vein thrombosis after laparoscopic cholecystectomy
J A Caprini1, J I Arcelus, M Laubach
1Department of Surgery, Glenbrook Hospital, Glenview, IL 60025, USA.
Surgical Endoscopy
|March 1, 1995
Summary
Laparoscopic cholecystectomy patients showed increased blood clotting potential post-surgery. However, a comprehensive prophylactic regimen significantly reduced deep-vein thrombosis (DVT) risk to just 1%.
Area of Science:
- Vascular Surgery
- Thrombosis Research
- Anesthesiology
Background:
- Laparoscopic cholecystectomy (LC) involves general anesthesia and specific positioning, potentially causing leg venous stasis and deep-vein thrombosis (DVT).
- Assessing hypercoagulability and DVT rates is crucial for optimizing patient safety during and after LC procedures.
Purpose of the Study:
- To evaluate the degree of postoperative hypercoagulability in patients undergoing LC.
- To determine the incidence of DVT in patients following LC.
- To assess the effectiveness of a combined mechanical and pharmacological prophylactic strategy.
Main Methods:
- 100 patients undergoing LC were monitored.
- Preoperative and postoperative Whole-blood thrombelastography (TEG) and plasma-activated partial thromboplastin time (PTT) were performed.
- All patients received graduated compression stockings and sequential pneumatic compression devices; selected patients received subcutaneous heparin.
Main Results:
- Significant postoperative hypercoagulability was observed, indicated by TEG index (P < 0.005) and PTT (P < 0.05).
- Only one patient (1%) developed an asymptomatic DVT.
- No adverse effects were reported from the prophylactic interventions.
Conclusions:
- Despite laboratory evidence of increased hypercoagulability after LC, a robust prophylactic regimen effectively minimizes DVT risk.
- The observed low DVT incidence suggests the prophylactic strategy employed is highly effective.