Coagulation activation after laparoscopic cholecystectomy in spite of thromboembolism prophylaxis

Background: The aim of this study was to determine whether laparoscopic cho lecystectomy (LC), in spite of its minimally invasive nature, causes coagul ation activation. Methods: Sixty-four patients undergoing LC were included prospectively. All received either dextran or low-molecular-weight heparin (LMWH). Blood samp les taken the morning of the operation and the following morning were analy zed for TATI FM, fragment 1+2, tPA, PAI-1, vWf, D-dimer. Hb, hematocrit. an d APC resistance. Results: Significant increases in TAT, FM, fragment 1+2, and D-dimer were s een, whereas APC resistance, Hb, and hematocrit decreased significantly. De xtran led to a decrease in vWf and no change in tPA, whereas LMWH led to an increase in both these parameters. Conclusions: Laparoscopic cholecystectomy causes coagulation activation. Th ere are differences in the response between patients receiving dextran and LMWH as thromboembolism prophylaxis. Since most patients are discharged the day after the operation, there could be practical as well as theoretical a dvantages to using dextran.