Safety of early laparoscopic cholecystectomy for patients with acute cholecystitis undergoing antiplatelet or anticoagulation therapy: a single-institution experience.

Abstract

BACKGROUND/AIMS:

Early cholecystectomy is recommended for patients with acute cholecystitis, particularly when less than 72 hours have passed since symptom onset. The safety of early laparoscopic cholecystectomy for patients receiving anticoagulants or antiplatelet agents is unclear. We retrospectively analyzed the safety of early laparoscopic cholecystectomy for patients with acute cholecystitis undergoing antiplatelet or anticoagulation therapy.

METHODOLOGY:

Between 2005 and 2012, a total of 239 patients were diagnosed with acute cholecystitis, 183 of whom underwent early laparoscopic cholecystectomy. We compared the clinical features and surgical outcomes of 21 patients undergoing antiplatelet or anticoagulation therapy with those of 162 patients not undergoing antiplatelet or anticoagulation therapy.

RESULTS:

Of the 21 patients, 15 patients took aspirin and four took clopidogrel sulfate. Three patients received dual therapy with two agents. The distributions of the severity of acute cholecystitis, a past history of abdominal operations, body mass index, blood test results, operation time, and blood loss were not significant between the two groups. Neither conversion to open surgery nor bleeding-related complications occurred in the patients undergoing antiplatelet and anticoagulation therapy.

CONCLUSIONS:

Early laparoscopic cholecystectomy for selected patients with acute cholecystitis undergoing antiplatelet and anticoagulation therapy is feasible and safe.

• Authors: Takehiro Noda, Hisanori Hatano, Keizo Dono, Junzo Shimizu, Kazuteru Oshima, Tsukasa Tanida, Masakazu Miyake, Takamichi Komori, Kenshu Kawanishi, Shunji Morita, Hiroshi Imamura, Takashi Iwazawa, Kenzo Akagi, Masashi Kitada
• Journal: Hepato-gastroenterology (Hepatogastroenterology) Vol. 61 Issue 134 Pg. 1501-6 (Sep 2014) ISSN: 0172-6390 [Print] Greece
• PMID: 25436333 (Publication Type: Journal Article)

Chemical References

• Anticoagulants
• Platelet Aggregation Inhibitors

Topics

• Aged
• Aged, 80 and over
• Anticoagulants (adverse effects, therapeutic use)
• Cholecystectomy, Laparoscopic (adverse effects)
• Cholecystitis, Acute (diagnosis, surgery)
• Feasibility Studies
• Female
• Humans
• Japan
• Male
• Middle Aged
• Patient Selection
• Platelet Aggregation Inhibitors (adverse effects, therapeutic use)
• Retrospective Studies
• Risk Factors
• Time-to-Treatment
• Treatment Outcome