Effect of antithrombotic therapy on postoperative outcome of 538 consecutive emergency laparoscopic cholecystectomies for acute cholecystitis: two Italian center's study.
Samuele VaccariAugusto LauroMaurizio CervelleraMaria Irene BelliniGiorgio PalazziniRoberto CirocchiValeria ToniniAndrea De VitoPublished in: Updates in surgery (2021)
The risk of developing hemorrhagic complications during or after emergency cholecystectomy (EC) for acute cholecystitis (AC) in patients with antithrombotic therapy (ATT) remains uncertain. In this double-center study, we evaluated post-operative outcomes in patients with ATT undergoing EC. We retrospectively evaluated 538 patients who underwent laparoscopic EC for AC between May 2015 and December 2019 at two referral centers. 89 of them (17%) were on ATT. We defined postoperative complication rates, including bleeding, as our primary outcome. Mortality was higher in the ATT group. Morbidity was higher in the ATT group as well; however, the difference was not statistically significant. 12 patients (2%) experienced intraoperative blood loss over 500 ml and ten (2%) had postoperative bleeding complications. Two patients (< 1%) experienced both intraoperative and postoperative bleeding. On multivariate analysis, ATT was not significantly associated with worse postoperative outcomes. Antithrombotic therapy is not an independently associated factor of severe postoperative complications (including bleeding) or mortality. However, these patients still represent a challenging group and must be carefully managed to avoid postoperative bleeding complications.
Keyphrases
- end stage renal disease
- patients undergoing
- atrial fibrillation
- ejection fraction
- chronic kidney disease
- newly diagnosed
- emergency department
- healthcare
- peritoneal dialysis
- public health
- stem cells
- type diabetes
- risk factors
- mesenchymal stem cells
- bone marrow
- coronary artery disease
- acute respiratory distress syndrome