Postoperative hypercoagulability and deep-vein thrombosis after laparoscopic cholecystectomy

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.