Laparoscopic cholecystectomy in patients undergoing anticoagulant therapy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1998-03

AUTHORS

Takanori Yoshida, Seigo Kitano, Toshifumi Matsumoto, Toshio Bandoh, Dolgor Baatar, Koichi Ninomiya, Tetsuo Hadama

ABSTRACT

We recently performed a laparoscopic cholecystectomy on three patients receiving preoperative oral anticoagulant therapy. The patients requiring anticoagulants for pre-existing cardiac conditions have the following risks at surgery: thromboembolism, hemorrhage, endocarditis, and cardiopulmonary dysfunction. In patients receiving anticoagulant therapy, one must thus maintain a balanced international normalized ratio of the prothrombin time to prevent thromboembolism or hemorrhage. Warfarin sodium was discontinued preoperatively in all patients. Heparin sodium was individualized according to each patient's risk of thromboembolism. As a result, these patients all underwent a laparoscopic cholecystectomy without complications. Attention was paid to achieve hemostasis in the operative field and the trocar inserted sites during the procedure. The administration of warfarin sodium was resumed on the first postoperative day in all patients. Restarting warfarin sodium early also helps to simplify postoperative management. A broad spectrum of antibiotic therapy was also used to reduce the risk of endocarditis. Each patient's cardiopulmonary function was carefully monitored. The minimal invasion experienced during a laparoscopic cholecystectomy may thus facilitate the management of gallstones in patients receiving systemic anticoagulation treatment based on the findings of this limited series. More... »

PAGES

308-312

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s005950050128

DOI

http://dx.doi.org/10.1007/s005950050128

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1052742948

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/9548316


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