caa a22 4500 475781651 CHVBK 20180406123646.0 cr unu---uuuuu 170329e20000201xx s 000 0 eng 10.1007/s004649900093 doi (NATIONALLICENCE)springer-10.1007/s004649900093 Videolaparoscopic cholecystectomy induces a hemostasis activation of lower grade than does open surgery [Elektronische Daten] [D. Prisco, A. De Gaudio, R. Carla, A. Gori, S. Fedi, A. Cella, G. Gensini, R. Abbate] Background: Tissue injury after trauma and surgery may induce alterations in blood coagulation and fibrinolysis, and the hypercoagulable state observed after surgery can be associated with the risk of postoperative thromboembolic complications. Recently, videolaparoscopic (VLPS) cholecystectomy has been introduced, and its advantages over the open procedure seem related to the reduced surgical trauma. The aim of this study was to investigate hemostatic system alterations in patients who undergo open and VLPS cholecystectomy. Methods: Fibrinogen, prothrombin fragment F1+2, D-dimer, and plasminogen activator inhibitor type-1 (PAI-1) activity was determined in 10 patients who underwent open (group A) and 10 patients who underwent VLPS cholecystectomy (group B), respectively. Blood samples were obtained the day of surgery in the morning (B1), after anesthesia (Aff1), 1 hour after the start of surgery (S1), then 30 min (E.05) and 24 h (E.24) after the surgery. Results: No significant differences were observed in baseline values between groups A and B for the parameters investigated. At 24 h after surgery, fibrinogen increased significantly (p < 0.05) in group A and also was significantly higher than in group B (p < 0.05). In group A, a marked increase in F1+2 levels (p < 0.01) was observed in all the samples, with the maximum values on the first day after surgery (3.7 nmol/l; 1.2-6.0 nmol/l), whereas in group B, a slight but significant increase in F1+2 levels (2.1 nmol/l; 1.1-3.9 nmol/l; p < 0.01) was observed only 30 min after the end of surgery. In both groups A and B, D-dimer markedly increased after surgery, without statistical significant differences between the two groups at any time. The PAI-1 activity plasma levels remained in the normal range during and after surgery in both groups. Conclusions: These results indicate that VLPS surgery induces an activation of the clotting system that, although of low degree and short duration, can lead to a transient prothrombotic state. Springer-Verlag New York Inc., 2000 Key words: Blood clotting activation — Open and videolaparoscopic cholecystectomy nationallicence Prisco D. Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy, Italy aut De Gaudio A. Istituto di Anestesia e Rianimazione, University of Florence, Florence, Italy, Italy aut Carla R. Istituto di Anestesia e Rianimazione, University of Florence, Florence, Italy, Italy aut Gori A. Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy, Italy aut Fedi S. Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy, Italy aut Cella A. Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy, Italy aut Gensini G. Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy, Italy aut Abbate R. Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy, Italy aut Surgical Endoscopy Springer-Verlag 14/2(2000-02-01), 170-174 0930-2794 14:2<170 2000 14 464 https://doi.org/10.1007/s004649900093 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004649900093 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Prisco D. Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy, Italy aut NATIONALLICENCE 700 1- De Gaudio A. Istituto di Anestesia e Rianimazione, University of Florence, Florence, Italy, Italy aut NATIONALLICENCE 700 1- Carla R. Istituto di Anestesia e Rianimazione, University of Florence, Florence, Italy, Italy aut NATIONALLICENCE 700 1- Gori A. Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy, Italy aut NATIONALLICENCE 700 1- Fedi S. Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy, Italy aut NATIONALLICENCE 700 1- Cella A. Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy, Italy aut NATIONALLICENCE 700 1- Gensini G. Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy, Italy aut NATIONALLICENCE 700 1- Abbate R. Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Viale Morgagni, 85, 50134 Florence, Italy, Italy aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/2(2000-02-01), 170-174 0930-2794 14:2<170 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer