Coagulation modifications after laparoscopic and open cholecystectomy in a swine model

N. T. Nguyen, J. D. Luketich, M. R. Shurin, Stephen M. Schatz, Q. Tran, J. Ravid, P. R. Schauer

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Background: The stress response to surgical trauma precipitates a state of transient hypercoagulation. Studies have demonstrated that laparoscopic surgery results in a diminished stress response compared to open surgery. The aim of this study was to determine the extent of postoperative hypercoagulability following laparoscopic cholecystectomy (LC) compared to open cholecystectomy (OC). Methods: Twenty-one pigs were randomly selected to undergo LC (N = 10) or OC (N = 11). Whole blood was collected preoperatively and on postoperative days (PODs) 1, 2, and 3 for determination of viscoelastic changes using a thromboelastography (TEG) coagulation analyzer. Four parameters were calculated from the TEG: R (reaction time), K (coagulation time), α (rate of clot formation), and MA (maximal amplitude). Antithrombin III (AT III) level was measured preoperatively and on POD 1. Results: After OC, three of four TEG parameters changed to reflect a state of hypercoagulation. Only MA values were significantly changed after LC. Comparison between OC and LC showed no difference in the TEG parameter. There was no significant change in AT III levels after LC or OC. Conclusions: OC results in postoperative hypercoagulation typically encountered in open abdominal surgery. Although there were no differences in TEG or AT III between the two groups, after the laparoscopic approach all but one TEG parameter remained unchanged, suggesting a diminished hypercoagulable state. By reducing postoperative hypercoagulation, laparoscopic surgery may reduce the risk of developing postoperative venous thrombosis.

Original languageEnglish (US)
Pages (from-to)973-978
Number of pages6
JournalSurgical Endoscopy
Volume12
Issue number7
DOIs
StatePublished - Jan 1 1998

Keywords

  • Hypercoagulable state
  • Hypercoagulation
  • Laparoscopic cholecystectomy
  • Pig
  • Thromboelastography

ASJC Scopus subject areas

  • Surgery

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