A STUDY OF ALTERATION IN COAGULATION PROFILE IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Introduction: Laparoscopic cholecystectomy has become the gold standard for the treatment of cholelithiasis. It has many advantages such as better cosmetic, shorter hospitalization time, minimal postoperative pain, early return to normal life. However carbon dioxide pneumoperitoneum may cause alteration in the coagulation system and moreover the reverse Trendelenburg position adopted diring surgery can induce blood stagnation in the lower limbs leading to a hypercoagulable state. The aim Objective: of the study was to record the effect of carbon dioxide pneumoperitoneum on coagulation factors and brinolysis response during laparoscopic cholecystectomy and to assess if there is any risk of postoperative thromboembolic complications following laparoscopic cholecystectomy. Methods: The hospital based descriptive study of 50 patients undergoing elective laparoscopic cholecystectomy was designed to study alteration in Clotting time, Prothrombin time(PT), Activated partial thrombin time(aPTT), Fibrinogen and D-dimer, which were measured preoperatively and 6 hour postoperatively. Out of 50 Results: patients operated 38 were female and 12 were male. Signicant decrease in PT and aPTT suggested activation of coagulation pathways while signicant increase in d-dimer and brinogen suggested activation of brinolytic systems. None of the patients had any postoperative thromboembolic complications. From the study we found that there was activati Discussions: on of coagulation and brinolysis after laparoscopic cholecystectomy leading to a hypercoagulable state which may be either due to carbon dioxide pneumoperitoneum or due to increased intraabdominal pressure. Although none of the patients had any thromboembolic complications postoperatively, however there may be the need to use prophylactic measures for thrombosis in high risk patients.