Disorders of Hemostasis in the Course and After Laparoscopic Cholecystectomy

Introduction: Hemostasis is a very important mechanism, whose changes can cause different complications. In the course of surgical interventions some changes in the system of coagulation happen. Laparoscopic cholecystectomy is a method of choice in the treatment of gallbladder calculosis. In the course of the procedure, parameters of hemostasis change, which stimulates a possible appearance of thromboembolic complications. The objective of our research was to reveal the changes in the system of coagulation in patients treated by laparoscopic cholecystectomy. Examinees and methods: Total sample involved 60 patients, divided into two groups, who were treated either by classical or laparoscopic method. Parameters of primary and secondary hemostasis were determined for the patients of both groups in Polyclinic for Transfusiology UKC Tuzla, before the operation, in the course, and 24 hours after the operation, and on the 5th day after the surgery. Results: Patients from both groups showed changes in the process of coagulation. The changes were more expressed in the group of patients treated by laparoscopic cholecystectomy. Very important result was the increased value of D-dimer measured on the 5th day after the operation in the patients operated by laparoscopic cholecystectomy, where value was 2.5 times higher in the relation to preoperative value (263.5 pg/1, so it was out of referential value). Increase of fibrinogen in both groups were an important result of this study. Discussion and conclusion: Results of the study showed changes in the process of coagulation in both groups, and increased fibrinolytic activity of the organism after laparoscopic cholecystectomy (requires a discussion on longer and thorough prophylaxis of tromboembolism).