An acute care surgery dilemma

Emergent laparoscopic cholecystectomy in patients on aspirin therapy

Bellal Joseph, Badi Rawashdeh, Hassan Aziz, Narong Kulvatunyou, Viraj Pandit, Qasim Jehangir, Terence OKeeffe, Andrew Tang, Donald J. Green, Randall S. Friese, Peter Rhee

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)689-694
Number of pages6
JournalAmerican Journal of Surgery
Volume209
Issue number4
DOIs
StatePublished - Apr 1 2015
Externally publishedYes

Fingerprint

Laparoscopic Cholecystectomy
Aspirin
Cholecystectomy
Anemia
Blood Transfusion
Therapeutics
Comorbidity
Conversion to Open Surgery
Postoperative Hemorrhage
Sex Ratio
Hemoglobins
Research Design
Outcome Assessment (Health Care)
Databases
Hemorrhage

Keywords

  • Acute cholecystitis
  • Aspirin therapy
  • Emergent cholecystectomy
  • Hemorrhagic complications

ASJC Scopus subject areas

  • Surgery

Cite this

Joseph, B., Rawashdeh, B., Aziz, H., Kulvatunyou, N., Pandit, V., Jehangir, Q., ... Rhee, P. (2015). An acute care surgery dilemma: Emergent laparoscopic cholecystectomy in patients on aspirin therapy. American Journal of Surgery, 209(4), 689-694. https://doi.org/10.1016/j.amjsurg.2014.04.014

An acute care surgery dilemma : Emergent laparoscopic cholecystectomy in patients on aspirin therapy. / Joseph, Bellal; Rawashdeh, Badi; Aziz, Hassan; Kulvatunyou, Narong; Pandit, Viraj; Jehangir, Qasim; OKeeffe, Terence; Tang, Andrew; Green, Donald J.; Friese, Randall S.; Rhee, Peter.

In: American Journal of Surgery, Vol. 209, No. 4, 01.04.2015, p. 689-694.

Research output: Contribution to journalArticle

Joseph, B, Rawashdeh, B, Aziz, H, Kulvatunyou, N, Pandit, V, Jehangir, Q, OKeeffe, T, Tang, A, Green, DJ, Friese, RS & Rhee, P 2015, 'An acute care surgery dilemma: Emergent laparoscopic cholecystectomy in patients on aspirin therapy', American Journal of Surgery, vol. 209, no. 4, pp. 689-694. https://doi.org/10.1016/j.amjsurg.2014.04.014
Joseph, Bellal ; Rawashdeh, Badi ; Aziz, Hassan ; Kulvatunyou, Narong ; Pandit, Viraj ; Jehangir, Qasim ; OKeeffe, Terence ; Tang, Andrew ; Green, Donald J. ; Friese, Randall S. ; Rhee, Peter. / An acute care surgery dilemma : Emergent laparoscopic cholecystectomy in patients on aspirin therapy. In: American Journal of Surgery. 2015 ; Vol. 209, No. 4. pp. 689-694.
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abstract = "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.",
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AU - Joseph, Bellal

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AU - Aziz, Hassan

AU - Kulvatunyou, Narong

AU - Pandit, Viraj

AU - Jehangir, Qasim

AU - OKeeffe, Terence

AU - Tang, Andrew

AU - Green, Donald J.

AU - Friese, Randall S.

AU - Rhee, Peter

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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.

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