Incidence of Deep Vein Thrombosis After Laparoscopic vs Minilaparotomy Cholecystectomy

摘要: Objectives To determine the frequency of deep vein thrombosis (DVT) associated with minimally invasive cholecystectomy and to determine, using minilaparotomy as a control operation, influence laparoscopic pneumoperitoneum on DVT formation. Design Prospective nonrandomized trial. Setting Tertiary care university hospital. Patients One hundred consecutive patients intended undergo either (59 patients) or (41 2 surgeons were prospectively enrolled between April 1996 1997. The group served controls isolate effect pneumoperitoneum. Patient details, operative any thromboembolic bleeding complications recorded. same thromboprophylaxis regimen was prescribed for each group; namely, preoperative postoperative subcutaneous low-molecular-weight heparin (LMWH), graduated compression stockings, intraoperative intermittent calf compression. Intervention Minimally cholecystectomy. Main Outcome Measure Frequency DVT. Bilateral lower limb venous color duplex scanning used detect Scans performed 3 occasions: (1) preoperatively admission hospital, (2) first day, (3) 4 weeks postoperatively. Results Three in underwent conversion conventional open There no significant differences groups age, sex, body mass index, white blood cell count, platelet prothrombin time, activated partial thromboplastin time. elective vs emergency operations, public hospital private admissions, consultant resident surgeon. Macroscopic gallbladder pathology grades both not significantly different, there difference duration stay. Operative cholangiography larger proportion cases (86% 66% χ test, P =.002), anesthesia longer operation (118 minutes 98 minutes; t =.05). Ninety-seven received LMWH all compression, LMWH. Two 100 had DVT, 1 after Both DVTs detected by examination day. found who did receive 40 an additional scan operation. Conclusions Despite theoretical risk disease due use pneumoperitoneum, is low if adequate provided.