THE INFLUENCE OF LAPAROSCOPIC CHOLECYSTECTOMY ON PERIOPERATIVE BLOOD-CLOTTING AND FIBRINOLYSIS

In order to investigate changes in coagulation and fibrinolysis arisin g during and after laparoscopic surgery me studied 24 patients, who we re operated on because of biliary lithiasis [21 females, three males, aged 36-69 (mean 50) years]. The reference group consisted of 17 patie nts, who were operated on traditionally [15 females, two males, aged 2 5-72 (mean 55) years]. Blood samples were taken from cubital vein 24 h prior to the operation, during the cholecystectomy, on the 1st and 3r d postoperative days. Additionally, before and during operation blood was sampled simultaneously from femoral vein. Both groups had similar perioperative values of platelet count, fibrinogen and t-PA Ag. Patien ts operated on laparoscopically had generally lower values of F1+2 and plasmin-alpha(2)-antiplasmin complexes, and intra-operative PAI-1 act ivity than those operated on traditionally. Test values in blood sampl ed simultaneously from femoral and cubital veins mere not statisticall y different. The data obtained show that generation of thrombin and pl asmin is lower in patients operated on laparoscopically compared with those having traditional surgery. Venous stasis during laparoscopic ch olecystectomy in lower extremities does not cause local alterations in hemostasis.