Changes in Coagulation and Fibrinolysis During Laparoscopic Cholecystectomy

Marakis, Georgios; Pavlidis, Theodosios; Ballas, Konstantinos; Karvounaris, Dimitrios; Rafailidis, S.; Sakantamis, Athanasios K.

doi:10.1089/lap.2006.16.582

Cited by 10 publications

(8 citation statements)

References 17 publications

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“…In explaining this finding, increased mean PT following laparoscopic cholecystectomy surgery can be attributed to the activity of the patients' coagulation systems, and the fact that coagulation proteins and the laparoscopic technique may cause a highly severe catabolic liver response to the liver after the surgery (15). Additionally, the change in the PT factor is related to the laboratory kit, and the lack of change in the INR level is consistent with the results of a study carried out by Marakis et al (19). Concerning the relative stability of the INR level, it can be argued that the laparoscopic cholecystectomy can reduce the activation of the hemostatic mechanism, such that in the event of clotting, stimulates the fibrinolytic system and causes the release of a proteolytic enzyme called plasmin.…”

Section: Discussionsupporting

confidence: 87%

Examining the Effect of Laparoscopic Cholecystectomy on Coagulation Tests Among Patients Undergoing the Surgery in Ali Ibn Abi Taleb Hospital in Zahedan in 2018

Shahraki

khazayi

Mohammadi

et al. 2021

Zahedan J Res Med Sci

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Background: Laparoscopic cholecystectomy, one of the most common elective surgical procedures, is a minimally invasive surgical procedure for patients with gallbladder diseases. Objectives: This study aimed to evaluate the effect of laparoscopic cholecystectomy on coagulation tests among patients undergoing the surgery in Ali Ibn Abi Taleb Hospital in Zahedan. Methods: Following a quasi-experimental design, 21 cases scheduled for laparoscopic cholecystectomy for whatever reasons at Ali Ibn Abi Taleb Hospital in Zahedan (Iran) were selected. To study the serum levels of blood factors, blood samples were collected at three stages, i.e., before the surgery (time point 1), 30 minutes after pumping the carbon dioxide gas into the abdomen (time point 2), and 30 minutes after removing the last port from the abdomen (time point 3). Data were analyzed using repeated measures. Results: According to the findings, laparoscopic cholecystectomy surgery only had a significant effect on the PT coagulation factor at the 99% confidence level. Also, PT was increased and significantly differed at time points 2 (30 minutes after pumping) and 3 (30 minutes after removing the port) compared to time point 1 (30 minutes before the surgery). Conclusions: Generally, it can be argued that despite observing some variations in the PT coagulation factor during the laparoscopic surgery, the INR level did not change. Hence, it can be considered as a safe surgical intervention for renal and liver functions.

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Section: Discussionsupporting

confidence: 87%

Examining the Effect of Laparoscopic Cholecystectomy on Coagulation Tests Among Patients Undergoing the Surgery in Ali Ibn Abi Taleb Hospital in Zahedan in 2018

Shahraki

khazayi

Mohammadi

et al. 2021

Zahedan J Res Med Sci

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“…Thromboembolic risks increase with those changes in hemostasis mechanism [ 19 ]. Despite PP, laparoscopic surgery has lower thromboembolic risks compared to open surgery [ 3 , 20 , 31 , 32 ]. Half of the postoperatively diagnosed DVT occurs during the surgical intervention itself.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effects of spinal epidural and general anesthesia on coagulation and fibrinolysis in laparoscopic cholecystectomy: a randomized controlled trial: VSJ Competition, 2 place.

Demiryas¹,

Dönmez²,

Erdem³

et al. 2017

Videosurgery and Other Miniinvasive Techniques

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IntroductionLaparoscopic cholecystectomy (LC) is usually performed under general anesthesia. Recently, laparoscopic cholecystectomy under regional anesthesia has become popular, but this creates a serious risk of thromboembolism because of pneumoperitoneum, anesthesia technique, operative positioning, and patient-specific risk factors.AimThis randomized controlled trial compares the effects of two different anesthesia techniques in laparoscopic cholecystectomy on coagulation and fibrinolysis.Material and methodsThis randomized prospective study included 60 low-risk patients with deep vein thrombosis (DVT) who underwent elective LC without thrombo-emboli prophylaxis. The patients were randomly divided into two groups according to the anesthesia technique: the general anesthesia (group 1, n = 30) and spinal epidural anesthesia (group 2, n = 30) groups. Measurement of the prothrombin time (PT), thrombin time (TT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), and blood levels of D-dimer (DD) and fibrinogen (F) were recorded preoperatively (pre), at the first hour (post 1) and 24 h (post 24) after the surgery. These results were compared both between and within the groups.ResultsThe mean age was 51.5 ±16.7 years (range: 19–79 years). Pneumoperitoneum time was similar between group 1 (33.8 ±7.8) and group 2 (34.8 ±10.4). The TT levels significantly declined postoperatively in both groups. The levels of PT, aPTT, INR, D-dimer and fibrinogen dramatically increased postoperatively in both groups.ConclusionsWhile there was not any DVT, there was a significant decline in TT. There was a dramatic rise in the PT, INR, D-dimer, fibrin degradation products (FDP), and fibrinogen following LC. This may be attributed to the effects of pneumoperitoneum and anesthesia techniques on portal vein flow.

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“…An LC carries a low risk of DVT ( Blake, Toker & Dunn, 2001 ). Although INR, and fibrinogen increased in the 24th postoperative hour, affects and disturbs the coagulation cascade, there are studies that present contradictory findings ( Marakis et al, 2006 ). It has been shown that D-dimer was the only true sensitive marker of coagulation and fibrinolysis whereas the other parameters such as PT, APTT are indirect indicators of coagulation of fibrinolysis ( Milic et al, 2007 ).…”

Section: Discussionmentioning

confidence: 99%

Is there any effect of pneumoperitoneum pressure on coagulation and fibrinolysis during laparoscopic cholecystectomy?

Dönmez¹,

Uzman

Dogan

et al. 2016

PeerJ

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BackgroundLaparoscopic cholecystectomies (LC) are generally performed in a 12 mmHg-pressured pneumoperitoneum in a slight sitting position. Considerable thromboembolism risk arises in this operation due to pneumoperitoneum, operation position and risk factors of patients. We aim to investigate the effect of pneumoperitoneum pressure on coagulation and fibrinolysis under general anesthesia.Material and MethodsFifty American Society of Anesthesiologist (ASA) I–III patients who underwent elective LC without thromboprophlaxis were enrolled in this prospective study. The patients were randomly divided into two groups according to the pneumoperitoneum pressure during LC: the 10 mmHg group (n = 25) and the 14 mmHg group. Prothrombin time (PT), thrombin time (TT), International Normalized Ratio (INR), activated partial thromboplastin time (aPTT) and blood levels of d-dimer and fibrinogen were measured preoperatively (pre), one hour (post1) and 24 h (post24) after the surgery. Moreover, alanine amino transferase, aspartate amino transferase and lactate dehydrogenase were measured before and after the surgery. These parameters were compared between and within the groups.ResultsPT, TT, aPTT, INR, and D-dimer and fibrinogen levels significantly increased after the surgery in both of the groups. D-dimer level was significantly higher in 14-mmHg group at post24.ConclusionBoth the 10-mmHg and 14-mmHg pressure of pneumoperitoneum may lead to affect coagulation tests and fibrinogen and D-dimer levels without any occurrence of deep vein thrombosis, but 14-mmHg pressure of pneumoperitoneum has a greater effect on D-dimer. However, lower pneumoperitoneum pressure may be useful for the prevention of deep vein thrombosis.

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Changes in Coagulation and Fibrinolysis During Laparoscopic Cholecystectomy

Abstract: Reduced coagulation activity and increased fibrinolytic activity occur during and after laparoscopic cholecystectomy.

Cited by 10 publications

References 17 publications

Examining the Effect of Laparoscopic Cholecystectomy on Coagulation Tests Among Patients Undergoing the Surgery in Ali Ibn Abi Taleb Hospital in Zahedan in 2018

Examining the Effect of Laparoscopic Cholecystectomy on Coagulation Tests Among Patients Undergoing the Surgery in Ali Ibn Abi Taleb Hospital in Zahedan in 2018

Comparison of the effects of spinal epidural and general anesthesia on coagulation and fibrinolysis in laparoscopic cholecystectomy: a randomized controlled trial: VSJ Competition, 2 place.

Is there any effect of pneumoperitoneum pressure on coagulation and fibrinolysis during laparoscopic cholecystectomy?

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