Alteration of Coagulation Profile during Laparoscopic Cholecystectomy

Objectives: The present study was to determine the coagulation profile alteration in laparoscopic cholecystectomy and to assessed the risk of thrombosis and prophylaxis for deep vein thrombosis in post operatively patients. Methods: A detailed history, clinical examinations and relevant investigations were performed to all patients. Blood samples were taken preoperatively, 6 h after surgery and 24 h after surgery. Peripheral venous blood was collected in 3.8% sodium citrate at a ratio of nine parts blood to one part anticoagulant (1:10 ratio). Blood was centrifuged within 30 min and plasma kept at 80o C until analysis. Samples were processed for PT-INR, platelet count, D-Dimer. A total of 80 patients were enrolled. 40 patients (CASE) were undergone elective laparoscopic cholecystectomy. And 40 patients (CONTROL) were undergone open elective surgeries for benign lesions under general anesthesia with operative duration ≤ 2hrs. The values had recorded in case record proforma. Results: In the Case group, 42.5% of the patients with a 24hr Post-op Platelet level between 150 and 250, while 57.5% fall within the range of 251 to 400. In the Control group, 47.5% of the patients had a platelet level between 150 and 250, and 52.5% fall within the range of 251 to 400. Similarly, in the Case group, 47.5% of the patients with a 24hr Post-op PT-INR level between 0.8 and 1.0, 35.0% fall within the range of 1.1 to 1.2, and 17.5% had levels greater than 1.2. In the Control group, 45.0% of the patients with a PT-INR level between 0.8 and 1.0, 27.5% fall within the range of 1.1 to 1.2, and 27.5% had levels greater than 1.2. Conclusions: Coagulation parameters, particularly D-Dimer levels showed significant postoperative changes. The consistent distribution of PT- INR and Platelet levels within the normal range in both groups suggests that these parameters were less impacted by the surgical procedure than D-Dimer levels. And it emphasizes the critical need for tailored anticoagulation strategies and comprehensive postoperative monitoring to mitigate the risks of thromboembolic events and ensure optimal patient outcomes.