Changes in coagulation and fibrinolysis during laparoscopic cholecystectomy.

Background: The influence of laparoscopic cholecystectomy on coagulation and fibrinolysis is debatable. There have been a few but controversial studies and the need for routine antithrombotic prophylaxis is unclear.
Materials and Methods: In this prospective study we investigated changes in coagulation and fibrinolysis parameters in laparoscopic cholecystectomy. Blood samples taken before, during, and after surgery from 38 consecutive patients were analyzed. Measured parameters included the international normalized ratio, prothrombin time, partial thromboplastin time, antithrombin III activity, platelet count, mean platelet volume, fibrinogen, and D-dimers.
Results: Statistically significant changes included increased perioperative international normalized ratio and D-dimers, and postoperative antithrombin III, fibrinogen, and D-dimers, as well as decreased perioperative antithrombin III and fibrinogen and postoperative international normalized ratio, platelet count, and mean platelet volume. Values of partial thromboplastin time had no statistically significant changes.
Conclusion: Reduced coagulation activity and increased fibrinolytic activity occur during and after laparoscopic cholecystectomy.