TY - JOUR
T1 - An acute care surgery dilemma
T2 - Emergent laparoscopic cholecystectomy in patients on aspirin therapy
AU - Joseph, Bellal
AU - Rawashdeh, Badi
AU - Aziz, Hassan
AU - Kulvatunyou, Narong
AU - Pandit, Viraj
AU - Jehangir, Qasim
AU - O'Keeffe, Terence
AU - Tang, Andrew
AU - Green, Donald J.
AU - Friese, Randall S.
AU - Rhee, Peter
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Background The current literature regarding hemorrhagic complications in patients on long-term antiplatelet therapy undergoing emergent laparoscopic cholecystectomy is limited. The aim of our study was to describe hemorrhagic complications in patients on prehospital aspirin (ASP) therapy undergoing emergent cholecystectomy. Methods We performed a 1-year retrospective analysis of our prospectively maintained acute care surgery database. The 2 groups (ASP group vs No ASP group) were matched in a 1:1 ratio for age, sex, previous abdominal surgeries, and comorbidities. Primary outcome measures were intraoperative hemorrhage, postoperative anemia, need for blood transfusion, and conversion to open cholecystectomy. Intraoperative hemorrhage was defined as intraoperative blood loss of 100 mL; postoperative anemia was defined by 2 g/dL drop in hemoglobin. Results A total of 112 (ASP: 56, no ASP: 56) patients were included in the analysis. The mean age was 65.9 ± 10 years, and 50% were male. There was no difference in age (P =.9), sex (P =.9), and comorbidities (P =.7) between the 2 groups. There was no difference in intraoperative blood loss >100 mL (P =.5), postoperative anemia (P =.8), blood transfusion requirement (P =.9), and conversion to open surgery (P =.7) between patients on American Society of Anesthesiologists therapy and patients not on American Society of Anesthesiologists therapy. Conclusions Emergent laparoscopic cholecystectomy is a safe procedure in patients on long-term ASP. Prehospital use of ASP as an independent factor should not be used to delay emergent cholecystectomy.
AB - Background The current literature regarding hemorrhagic complications in patients on long-term antiplatelet therapy undergoing emergent laparoscopic cholecystectomy is limited. The aim of our study was to describe hemorrhagic complications in patients on prehospital aspirin (ASP) therapy undergoing emergent cholecystectomy. Methods We performed a 1-year retrospective analysis of our prospectively maintained acute care surgery database. The 2 groups (ASP group vs No ASP group) were matched in a 1:1 ratio for age, sex, previous abdominal surgeries, and comorbidities. Primary outcome measures were intraoperative hemorrhage, postoperative anemia, need for blood transfusion, and conversion to open cholecystectomy. Intraoperative hemorrhage was defined as intraoperative blood loss of 100 mL; postoperative anemia was defined by 2 g/dL drop in hemoglobin. Results A total of 112 (ASP: 56, no ASP: 56) patients were included in the analysis. The mean age was 65.9 ± 10 years, and 50% were male. There was no difference in age (P =.9), sex (P =.9), and comorbidities (P =.7) between the 2 groups. There was no difference in intraoperative blood loss >100 mL (P =.5), postoperative anemia (P =.8), blood transfusion requirement (P =.9), and conversion to open surgery (P =.7) between patients on American Society of Anesthesiologists therapy and patients not on American Society of Anesthesiologists therapy. Conclusions Emergent laparoscopic cholecystectomy is a safe procedure in patients on long-term ASP. Prehospital use of ASP as an independent factor should not be used to delay emergent cholecystectomy.
KW - Acute cholecystitis
KW - Aspirin therapy
KW - Emergent cholecystectomy
KW - Hemorrhagic complications
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U2 - 10.1016/j.amjsurg.2014.04.014
DO - 10.1016/j.amjsurg.2014.04.014
M3 - Article
C2 - 25064416
AN - SCOPUS:84925342353
SN - 0002-9610
VL - 209
SP - 689
EP - 694
JO - American journal of surgery
JF - American journal of surgery
IS - 4
ER -