Venous thromboembolism after laparoscopic cholecystectomy: clinical burden and prevention

Abstract

Background: The clinical benefit of prophylaxis for venous thromboembolism (VTE) in laparoscopic cholecystectomy is unclear. This study aimed to assess the clinical burden of VTE and the efficacy and safety of antithrombotic prophylaxis during laparoscopic cholecystectomy.

Methods: Data sources and study selection studies were searched in MEDLINE and Embase using the terms "cholecystectomy and venous thrombosis" and "cholecystectomy and venous thromboembolism." Studies were considered for a systematic review and a metaanalysis if they reported on the methods of antithrombotic prophylaxis and on the incidence of objectively confirmed VTE in patients who had undergone laparoscopic cholecystectomy. Overall, 15 studies of patients who had undergone laparoscopic cholecystectomy were included in the systematic review.

Results: The incidence of VTE was lower after laparoscopic cholecystectomy than after open cholecystectomy [odds ratio (OR), 0.47; 95 % confidence interval (CI), 0.40-0.56]. No statistically significant reduction in VTE was observed in patients receiving heparin prophylaxis after laparoscopic cholecystectomy (OR, 0.86; 95 % CI, 0.12-5.82).

Conclusions: The rate of VTE after laparoscopic cholecystectomy seems to be relatively low. The clinical benefit of heparin prophylaxis for patients undergoing laparoscopic cholecystectomy remains unclear.