Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass

N. T. Nguyen, John T Owings, R. Gosselin, William C Pevec, S. J. Lee, C. Goldman, B. M. Wolfe, D. B. McConnell, R. G. Latimer, J. K. Horn, Owings

Research output: Contribution to journalArticle

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Abstract

Hypothesis: Laparoscopic gastric bypass (GBP) induces a postoperative hypercoagulable state that is similar or reduced compared with open GBP. Setting: University hospital. Patients: Between May 1999 and June 2000, 70 patients were randomly assigned to laparoscopic (n=36) or open (n=34) GBP. Deep venous thrombosis (DVT) prophylaxis consisted of antiembolism stockings and sequential pneumatic compression devices. Main Outcome Measures: Plasminogen, thrombin-antithrombin complex (TAT), prothrombin fragment 1.2 (F1.2), fibrinogen, D-dimer, antithrombin III (AT), and protein C levels were measured at baseline and at 1, 24, 48, and 72 hours postoperatively. A venous duplex examination of both lower extremities was performed preoperatively and between the third and fifth day postoperatively. Results: The 2 groups were similar in age, weight, and body mass index. Plasminogen levels decreased, and TAT, F1.2, and fibrinogen levels increased after laparoscopic and open GBP. There was no significant difference in these levels between groups. D-dimer levels increased in both groups, but the levels were significantly higher after open GBP than after laparoscopic GBP (P<.01). Antithrombin III and protein C levels decreased in both groups. The reduction of AT (at 1 hour) and protein C (at 72 hours) was significantly less after laparoscopic GBP than after open GBP (P<.05). Postoperative venous duplex examination revealed DVT in 1 (2.9%) of 34 patients after open GBP but in none of 36 patients after laparoscopic GBP. One patient developed pulmonary embolism after open GBP. Conclusions: Laparoscopic GBP induces a hypercoagulable state similar to that of open GBP. Our findings suggest that DVT prophylaxis should be used during laparoscopic GBP as in open GBP.

Original languageEnglish (US)
Pages (from-to)909-916
Number of pages8
JournalArchives of Surgery
Volume136
Issue number8
StatePublished - 2001

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Gastric Bypass
Fibrinolysis
Antithrombin III
Protein C
Venous Thrombosis
Antithrombin Proteins
Plasminogen
Fibrinogen
Intermittent Pneumatic Compression Devices
Pulmonary Embolism

ASJC Scopus subject areas

  • Surgery

Cite this

Nguyen, N. T., Owings, J. T., Gosselin, R., Pevec, W. C., Lee, S. J., Goldman, C., ... Owings (2001). Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass. Archives of Surgery, 136(8), 909-916.

Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass. / Nguyen, N. T.; Owings, John T; Gosselin, R.; Pevec, William C; Lee, S. J.; Goldman, C.; Wolfe, B. M.; McConnell, D. B.; Latimer, R. G.; Horn, J. K.; Owings.

In: Archives of Surgery, Vol. 136, No. 8, 2001, p. 909-916.

Research output: Contribution to journalArticle

Nguyen, NT, Owings, JT, Gosselin, R, Pevec, WC, Lee, SJ, Goldman, C, Wolfe, BM, McConnell, DB, Latimer, RG, Horn, JK & Owings 2001, 'Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass', Archives of Surgery, vol. 136, no. 8, pp. 909-916.
Nguyen, N. T. ; Owings, John T ; Gosselin, R. ; Pevec, William C ; Lee, S. J. ; Goldman, C. ; Wolfe, B. M. ; McConnell, D. B. ; Latimer, R. G. ; Horn, J. K. ; Owings. / Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass. In: Archives of Surgery. 2001 ; Vol. 136, No. 8. pp. 909-916.
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abstract = "Hypothesis: Laparoscopic gastric bypass (GBP) induces a postoperative hypercoagulable state that is similar or reduced compared with open GBP. Setting: University hospital. Patients: Between May 1999 and June 2000, 70 patients were randomly assigned to laparoscopic (n=36) or open (n=34) GBP. Deep venous thrombosis (DVT) prophylaxis consisted of antiembolism stockings and sequential pneumatic compression devices. Main Outcome Measures: Plasminogen, thrombin-antithrombin complex (TAT), prothrombin fragment 1.2 (F1.2), fibrinogen, D-dimer, antithrombin III (AT), and protein C levels were measured at baseline and at 1, 24, 48, and 72 hours postoperatively. A venous duplex examination of both lower extremities was performed preoperatively and between the third and fifth day postoperatively. Results: The 2 groups were similar in age, weight, and body mass index. Plasminogen levels decreased, and TAT, F1.2, and fibrinogen levels increased after laparoscopic and open GBP. There was no significant difference in these levels between groups. D-dimer levels increased in both groups, but the levels were significantly higher after open GBP than after laparoscopic GBP (P<.01). Antithrombin III and protein C levels decreased in both groups. The reduction of AT (at 1 hour) and protein C (at 72 hours) was significantly less after laparoscopic GBP than after open GBP (P<.05). Postoperative venous duplex examination revealed DVT in 1 (2.9{\%}) of 34 patients after open GBP but in none of 36 patients after laparoscopic GBP. One patient developed pulmonary embolism after open GBP. Conclusions: Laparoscopic GBP induces a hypercoagulable state similar to that of open GBP. Our findings suggest that DVT prophylaxis should be used during laparoscopic GBP as in open GBP.",
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T1 - Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass

AU - Nguyen, N. T.

AU - Owings, John T

AU - Gosselin, R.

AU - Pevec, William C

AU - Lee, S. J.

AU - Goldman, C.

AU - Wolfe, B. M.

AU - McConnell, D. B.

AU - Latimer, R. G.

AU - Horn, J. K.

AU - Owings,

PY - 2001

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N2 - Hypothesis: Laparoscopic gastric bypass (GBP) induces a postoperative hypercoagulable state that is similar or reduced compared with open GBP. Setting: University hospital. Patients: Between May 1999 and June 2000, 70 patients were randomly assigned to laparoscopic (n=36) or open (n=34) GBP. Deep venous thrombosis (DVT) prophylaxis consisted of antiembolism stockings and sequential pneumatic compression devices. Main Outcome Measures: Plasminogen, thrombin-antithrombin complex (TAT), prothrombin fragment 1.2 (F1.2), fibrinogen, D-dimer, antithrombin III (AT), and protein C levels were measured at baseline and at 1, 24, 48, and 72 hours postoperatively. A venous duplex examination of both lower extremities was performed preoperatively and between the third and fifth day postoperatively. Results: The 2 groups were similar in age, weight, and body mass index. Plasminogen levels decreased, and TAT, F1.2, and fibrinogen levels increased after laparoscopic and open GBP. There was no significant difference in these levels between groups. D-dimer levels increased in both groups, but the levels were significantly higher after open GBP than after laparoscopic GBP (P<.01). Antithrombin III and protein C levels decreased in both groups. The reduction of AT (at 1 hour) and protein C (at 72 hours) was significantly less after laparoscopic GBP than after open GBP (P<.05). Postoperative venous duplex examination revealed DVT in 1 (2.9%) of 34 patients after open GBP but in none of 36 patients after laparoscopic GBP. One patient developed pulmonary embolism after open GBP. Conclusions: Laparoscopic GBP induces a hypercoagulable state similar to that of open GBP. Our findings suggest that DVT prophylaxis should be used during laparoscopic GBP as in open GBP.

AB - Hypothesis: Laparoscopic gastric bypass (GBP) induces a postoperative hypercoagulable state that is similar or reduced compared with open GBP. Setting: University hospital. Patients: Between May 1999 and June 2000, 70 patients were randomly assigned to laparoscopic (n=36) or open (n=34) GBP. Deep venous thrombosis (DVT) prophylaxis consisted of antiembolism stockings and sequential pneumatic compression devices. Main Outcome Measures: Plasminogen, thrombin-antithrombin complex (TAT), prothrombin fragment 1.2 (F1.2), fibrinogen, D-dimer, antithrombin III (AT), and protein C levels were measured at baseline and at 1, 24, 48, and 72 hours postoperatively. A venous duplex examination of both lower extremities was performed preoperatively and between the third and fifth day postoperatively. Results: The 2 groups were similar in age, weight, and body mass index. Plasminogen levels decreased, and TAT, F1.2, and fibrinogen levels increased after laparoscopic and open GBP. There was no significant difference in these levels between groups. D-dimer levels increased in both groups, but the levels were significantly higher after open GBP than after laparoscopic GBP (P<.01). Antithrombin III and protein C levels decreased in both groups. The reduction of AT (at 1 hour) and protein C (at 72 hours) was significantly less after laparoscopic GBP than after open GBP (P<.05). Postoperative venous duplex examination revealed DVT in 1 (2.9%) of 34 patients after open GBP but in none of 36 patients after laparoscopic GBP. One patient developed pulmonary embolism after open GBP. Conclusions: Laparoscopic GBP induces a hypercoagulable state similar to that of open GBP. Our findings suggest that DVT prophylaxis should be used during laparoscopic GBP as in open GBP.

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