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      Results of post-laparoscopic cholecystectomy duplex scan without deep vein thrombosis prophylaxis prior to surgery

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          Abstract

          Backgrounds

          There are controversies among surgeons about prophylaxis of deep vein thrombosis (DVT) in laparoscopic cholecystectomy. The aim of this study was the assessment of patients’ condition after laparoscopic cholecystectomy without any prophylactic measure.

          Methods

          100 cases of laparoscopic cholecystectomy without DVT prophylaxis were followed by duplex scanning in the first postoperative day and by physical examination and patient history at the first to second postoperative week however no clinical sign was found for DVT.

          Results

          Only one case of partially thrombosis (1%) was found by duplex scanning which was managed conservatively.

          Conclusion

          Laparoscopic cholecystectomy may consider as a low-risk procedure and routine prophylaxis may not be justified in the absence of other risk factor.

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          Most cited references10

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          Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases.

          M Airan, A Doolas, K. Millikan … (1992)
          Complications of laparoscopic cholecystectomy were evaluated by a survey of surgical department chairpersons at 4,292 US hospitals. The 77,604 cases were reported by 1,750 respondents. Laparotomy was required for treatment of a complication in 1.2% of patients. The mean rate of bile duct injury (exclusive of cystic duct) was 0.6% and was significantly lower at institutions that had performed more than 100 cases. Bile duct injuries were recognized postoperatively in half of the cases and most frequently required anastomotic repair. Intraoperative cholangiography was practiced selectively by 52% of the respondents and routinely by 31%. Bowel and vascular injuries, which occurred in 0.14% and 0.25% of cases, respectively, were the most lethal complications. Postoperative bile leak was recognized in 0.3% of patients, most commonly originating from the cystic duct. Eighteen of 33 postoperative deaths resulted from operative injury. These data demonstrate that laparoscopic cholecystectomy is associated with low rates of morbidity and mortality but a significant rate of bile duct injury.
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            Coagulation status and the presence of postoperative deep vein thrombosis in patients undergoing laparoscopic cholecystectomy.

            D Milic, V Pejcic, S Zivic … (2007)
            Venous thromboembolism is a relevant social and health care problem because of its high incidence among patients who undergo surgery (20-30% after general surgical operations and 50-75% after orthopedic procedures), its pulmonary embolism-related mortality rate, and its long-term sequelae (postthrombotic syndrome and ulceration), which may be disabling. This study aimed to determine the coagulation status and the presence of postoperative deep vein thrombosis (DVT) in patients undergoing laparoscopic (LC) and open cholecystectomy (OC).
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              Venous thromboembolism in patients undergoing laparoscopic and arthroscopic surgery and in leg casts.

              David Bergqvist, Gordon Lowe (2002)
              The risk of venous thrombosis and need for prophylaxis in patients having undergone minimally invasive procedures and in patients immobilized in a leg plaster are poorly defined. We performed a literature search to evaluate the risk of developing venous thromboembolism after 2 minimally invasive procedures, laparoscopic surgery and arthroscopy, and in patients with lower limb plaster casts. Despite problems of "contamination" because some surgeons use prophylaxis in some of these patients, we were able to determine that (1) laparoscopic cholecystectomy can be considered a low-risk procedure and therefore routine use of prophylaxis is probably not justified; (2) patients undergoing arthroscopic knee surgery are at low to moderate risk and thus prophylaxis is optional; and (3) patients with plaster cast immobilization because of trauma have a moderate risk of thrombosis and should receive prophylaxis.
              Article 0 comments Cited 6 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Med J Islam Repub Iran
                Journal ID (iso-abbrev): Med J Islam Repub Iran
                Journal ID (publisher-id): MJIRI
                Title: Medical Journal of the Islamic Republic of Iran
                Publisher: Tehran University of Medical Sciences
                ISSN (Print): 1016-1430
                ISSN (Electronic): 2251-6840
                Publication date (Print): November 2012
                Volume: 26
                Issue: 4
                Pages: 164-166
                Affiliations
                [1 ]Fellowship of Laparoscopic Surgery, Minimally Invasive Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. pakaneh@ 123456tums.ac.ir
                [2 ]Assistant professor of laparoscopic surgery, Minimally Invasive Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
                [3 ]General Practitioner, Minimally Invasive Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. zeinabtamannaie@ 123456yahoo.com
                [4 ]Oncologic Surgeon. mhakimian@ 123456yahoo.com
                [5 ]Radiologist. zohrei@ 123456yahoo.com
                [6 ]Associated professor of gynecology fellowship of laparoscopic surgery, Minimally Invasive Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic Azad University, Tehran Branch. shahlachaichian@ 123456yahoo.com
                Author notes
                Corresponding author: Abdolreza Pazouki, Department of Laparoscopic Surgery, Minimally Invasive Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. Email: research@ 123456lapsurg.ir
                Article
                Publisher ID: MJIRI-26-164
                PMC ID: 3562536
                PubMed ID: 23482413
                SO-VID: c7f8ca41-8301-47c3-9b63-1ebdaec75942
                Copyright © © 2012 Tehran University of Medical Sciences
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                Date received : 14 February 2012
                Date revision received : 01 July 2012
                Date accepted : 08 August 2012
                Categories
                Subject: Original Article

                Keywords: deep vein thrombosis,laparoscopy,cholecystectomy,duplex scan
                Data availability:
                Keywords: deep vein thrombosis, laparoscopy, cholecystectomy, duplex scan

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