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Fibrinolytic activity in laparoscopic cholecystectomy
C Martinez-Ramos1, A Lopez-Pastor, J R Núñez-Peña
1Surgical Gastroenterological Department III, Hospital Clinico San Carlos, Facultad de Medicina, Universidad Complutense, Madrid, Spain.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|January 23, 1999
Summary
Laparoscopic cholecystectomy (LC) enhances plasma fibrinolytic activity, increasing tissue-type plasminogen activator (t-PA) post-surgery. This suggests a hypocoagulable state, potentially reducing thrombotic risk in patients undergoing LC.
Area of Science:
- Cardiovascular Medicine
- Surgical Oncology
- Hematology
Background:
- Laparoscopic cholecystectomy (LC) is a common surgical procedure.
- Assessing postoperative hemostatic changes is crucial for understanding thrombotic risk.
- Fibrinolytic activity plays a key role in preventing blood clots.
Purpose of the Study:
- To investigate changes in fibrinolytic activity following LC.
- To determine if these changes correlate with an increased risk of thrombosis.
- To compare fibrinolytic markers between LC and a control surgical group.
Main Methods:
- Studied 20 LC patients and 12 control patients undergoing herniorrhaphy.
- Measured plasma fibrinolytic activity (PFA), euglobulin fibrinolytic activity (EFA), tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), and D-dimer (D-D).
- Collected samples preoperatively, intraoperatively, and postoperatively (24 hours, 7 days).
Main Results:
- Fibrinolytic activity was enhanced in the immediate postoperative period for LC patients.
- A significant increase in postoperative t-PA was observed in LC patients (p<0.005).
- D-dimer levels increased postoperatively, returning to baseline by day seven, with no significant group differences.
Conclusions:
- LC leads to increased plasma fibrinolytic activity, likely due to t-PA release.
- This suggests a temporary hypocoagulable state after LC.
- The findings indicate a potentially lower thrombotic risk associated with LC compared to other procedures.