Ann Surg Treat Res.  2017 Mar;92(3):143-148. 10.4174/astr.2017.92.3.143.

The efficacy of laparoscopic cholecystectomy without discontinuation in patients on antithrombotic therapy

• Yun JH
• Jung HI
• Lee HU
• Baek MJ
• Bae SH

• KMID: 2377556
• DOI: http://doi.org/10.4174/astr.2017.92.3.143

Abstract

PURPOSE
Laparoscopic cholecystectomy (LC) is one of the most commonly performed surgeries in the world today. However, there is no consensus regarding whether LC can be performed in patients with acute cholecystitis while on antithrombotic therapy. The objective of our study was to describe postoperative outcomes of patients who underwent emergent LC without interruption to antithrombotic therapy.
METHODS
We performed a retrospective review of patients who underwent LC for acute cholecystitis while on antithrombotic therapy from 2010 to 2015 at Soonchunhyang Universtiy Cheonan Hospital. Patients were divided into 2 groups as underwent emergent LC and elective LC.
RESULTS
A total of 67 patients (emergent group, 22; elective group, 45) were included in the analysis. Elective group had significantly longer duration between the admission and operation (8 [7-10] days vs. 2 [1-3] days, P < 0.001) and longer duration of antithrombotic drugs discontinuation (7 days vs. 1 [0-3] days, P < 0.001). Emergent group had significantly more postoperative anemia (6 patients vs. 0 patient, P = 0.001) and 3 of 6 patients received packed RBC transfusion in postoperative period. However, there was no significant difference in length of postoperative stays, length of intensive care unit stays and mortality rates.
CONCLUSION
Emergent LC without interruption to antithrombotic therapy was relatively safe and useful. A well-designed multicenter study is needed to confirm the safety and efficacy of LC without suspension of antithrombotic therapy and to provide a simple guideline.

Keyword

Laparoscopic cholecystectomy; Acute cholecystitis; Antithrombotic therapy

MeSH Terms

Anemia
Cholecystectomy, Laparoscopic*
Cholecystitis, Acute
Chungcheongnam-do
Consensus
Humans
Intensive Care Units
Mortality
Postoperative Period
Retrospective Studies

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