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Clinical and Applied Thrombosis/Hemostasis, Vol. 12, No. 4, 421-426 (2006)
DOI: 10.1177/1076029606293425

Low Frequency of Phlebographic Deep Vein Thrombosis After Laparoscopic Cholecystectomy—A Pilot Study

Fredrik Lindberg, MD, PhD

Department of Surgery, Umeå University Hospital, Umeå, 0910.51345{at}telia.com

Martin Björck, MD, PhD

Department of Surgery, Uppsala University Hospital, Uppsala, Sweden

Ib Rasmussen, MD, PhD

Department of Surgery, Uppsala University Hospital, Uppsala, Sweden

Rickard Nyman, MD, PhD

Department of Radiology, Uppsala University Hospital, Uppsala, Sweden

David Bergqvist, MD, PhD

Department of Surgery, Uppsala University Hospital, Uppsala, Sweden

To investigate the rate of deep vein thrombosis (DVT) after laparoscopic surgery, 50 patients underwent bilateral phlebography 7-11 days after laparoscopic cholecystectomy (LC). All received thromboembolism prophylaxis, either low molecular weight heparin (LMWH) or dextran. Three patients were converted to open cholecystectomy. D-dimer was investigated preoperatively, on day 1 and on the day of phlebography. One asymptomatic DVT was found. One phlebogram was incomplete. Seven phlebograms were not optimal but of sufficient quality to rule out DVT. The frequency of DVT was thus 1 of 49 or 2.0% (95% confidence interval, 0-6.0%). No anticoagulants were prescribed after discharge. No patient developed late thromboembolic complications. D-dimer values increased significantly at day 1 and were further increased at the time of phlebography. The frequency of phlebographical DVTs thus seems to be low despite prophylaxis of questionable efficacy. The D-dimer values, however, suggest that the effects of LC on coagulation/fibrinolysis have a duration of longer than 1 week.

Key Words: Thromboembolic complications • Deep vein thrombosis • Laparoscopic cholecystectomy • Phlebography

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W. H. Geerts, D. Bergqvist, G. F. Pineo, J. A. Heit, C. M. Samama, M. R. Lassen, and C. W. Colwell
Prevention of Venous Thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest, June 1, 2008; 133(6_suppl): 381S - 453S.
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