Changes haemostasis parameters during cholecystectomy

It has long been known that a hypercoagulability state develops after surgery. The aim of the study was to evaluate the influence of chronic cholecystitis on haemostasis. Surgical operation at this diagnosis imply classic open cholecistectomy (so called OC method) and laparoscopic method (LC method). That was the criteria for category in two groups patients. The patients with acute cholecystitis were excluded. Prothrombin time, aPTT fibrinogen, antithrombin III (AT III), protein C, plasminogen and D-dimer levels were measured at baseline and at 1, 2, 3, 5 and 7 days after the operation. Plasma levels of haemostatic parameters were measured by spectrofotometric assay with chromogenic substrat, on BCS (Behring Coagulation System, Dade Behring). Preoperative parameters of hemostasis were normal in all the patients. Plasma levels of fibrinogen and D-dimer increased significantly in group OC. Plasma levels of AT III, protein C and plasminogen decreased in both groups. Patients received low-molecular heparin -Fraxarin. The investigation of hemostasis parameters on days 1, 2, 3, 5 and 7 after the operation showed that after laparoscopic cholecystectomy restores the balance in the hemostasis system by the 3rd day, and by the 7th day after open cholecystectomy. Recently laparoscopic cholecystectomy (LC) has advantages over the open procedure seem related to the reduced surgical trauma. LC is associated with a diminished acute-phase response and reduce the risk of thromboembolic complications one has to take into account the changes of hemostasis balance.