Taking antithrombic therapy during emergency laparoscopic cholecystectomy for acute cholecystitis does not affect the postoperative outcomes: a propensity score matched study

Kentaro Oji,Yasuhiko Mii,Yasunori Otowa,Keitaro Kakinoki,Yuta Yamazaki,Tetsu Nakamura,Keisuke Arai,Daisuke Kuroda

doi:10.1186/s12893-022-01501-6

Abstract

BackgroundContinuing antithrombic therapy (ATT) during surgery increases the risk of bleeding. However, it is difficult to discontinue the ATT in emergency surgery. Therefore, safety of emergency laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) is still unclear. We aimed to clarify the affect of ATT during emergency LC for AC.MethodsPatients with AC were classified into ATT group (n = 30) and non-ATT group (n = 120). Postoperative outcomes were compared after propensity score matching (n = 22).ResultsHigher level of c-reactive protein level and shorter activated partial thromboplastin time (APTT) was observed in ATT group than in non-ATT group after matching. No significant difference was found between other patient characteristics and perioperative results. Blood loss over 100 mL was observed in 8 patients. Multivariate analyze showed that APTT was an independent risk factor for bleeding over 100 mL (P = 0.039), while ACT and APT was not.ConclusionsTaking ATT does not affect the blood loss or complications during emergency LC for AC. Controlling intraoperative bleeding is essential for a safe postoperative outcome.

Highlights

Continuing antithrombic therapy (ATT) during surgery increases the risk of bleeding
There was a trend of elder patients and more male in ATT group than in nonATT group
Higher Anesthesiologists-Physical Status (ASA-PS) and Charlson comorbidity Index (CCI) was observed in ages over 75 years old compared with age under 75 years old (P = 0.032 and P < 0.001, respectively)

Summary

Introduction

Continuing antithrombic therapy (ATT) during surgery increases the risk of bleeding. It is difficult to discontinue the ATT in emergency surgery. Safety of emergency laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) is still unclear. We aimed to clarify the affect of ATT during emergency LC for AC. Antithrombic therapy (ATT) is used to prevent primary and secondary thromboembolic complications after cardiovascular or cerebrovascular diseases and the use of ATT is more relevant in elder population [1, 2]. The safety of emergency LC for AC with ATT remains unclear. In this retrospective study, we aimed to clarify the affect of ATT during emergency LC for AC

Objectives

Methods

Results

Conclusion