Systematic Reviews
Copyright ©The Author(s) 2018.
World J Clin Cases. Nov 26, 2018; 6(14): 767-775
Published online Nov 26, 2018. doi: 10.12998/wjcc.v6.i14.767
Table 1 Reported data concerning bleeding complications of "basic" abdominal surgery in patients with antithrombotic therapy (antiplatelet therapy and/or anticoagulation therapy)
First author of the reportsYearSurgery typeDrug use and exposureBleeding eventsTE, mortality
Laparoscopic surgery (overall)
Fujikawa[10]2013Abdominal laparoscopic surgery (cholecystectomy (mostly), appendectomy, surgery for GI malignancy, liver resection, splenectomy etc)Patients with continued use of ASA (n = 52)PBC 0% in continued ASA vs 2.5% in discontinuation vs 0.7% in control (P = 0.987)TE 0% in continued ASA vs 0.6% in discontinued ASA vs 0.2% in control (P = 0.625)
Patients with discontinuation of APT (n = 160)Only one mortality in continued ASA group (1.9%)
Patients not on APT (control, n = 863)
Laparoscopic cholecystectomy
Ercan[11]2010Laparoscopic cholecystectomy (only elective)Patients with ACT (w/ bridging, n = 44)PBC 25% in ACT vs 1.5% in control (P < 0.001)(not mentioned)
Patients without ACT (control, n = 1377)One mortality due to severe bleeding
Ono[12]2013Laparoscopic cholecystectomy (n = 270) or Laparoscopic colorectal cancer resection (n = 218)Patients with continued ASA (n = 52)SBL 27 mL in continued ASA vs 17 mL in control (P = 0.430)No mortality in both groups
Patients without ASA (control, n = 436)
Anderson[13]2014Laparoscopic cholecystectomy (elective and emergency)Patients with continued clopidogrel (n = 36)No difference in SBL (49 g vs 47 g, P = 0.85)No TE in both groups
Matched patients without clopidogrel (control, n = 36)PBC 0% in clopidogrel vs 2.8% in control (P = 0.31)No mortality in both groups
Noda[14]2014Early laparoscopic cholecystectomy for acute cholecystitisPatients with continued use of ATT (n = 21)No conversion to open surgeryNo mortality in both groups
Patients without ATT (n = 162)No PBC in both groups
Joseph[15]2015Emergency laparoscopic cholecystectomyPatients with continued use of APT (n = 56), including those with preop Plt transfusion (n = 12)SBL ≥ 100 mL 14.3% in continued ASA vs 9% in control (P = 0.50)No difference in the rates of overall postop complications (8.9% vs 7.1%, P = 0.80)
Patients without APT (control, n = 56)No mortality in both groups
Fujikawa[16]2017Emergency cholecystectomy including 106 laparoscopic surgery for acute cholecystitisPatients with continued use of APT (n = 89)SBL ≥ 500 mL 12% in continued APT vs 5% in control (P = 0.240)TE 1.1% in continued APT vs 0% in control (P = 0.37)
Patients without APT (control, n = 154)PBC 7% in multiple APT vs 3% in single APT vs 0.6% in control (P = 0.027)No mortality in both groups
Sakamoto[17]2017Laparoscopic cholecystectomy (only elective operation)Patients with continued single APT (n = 49)SBL ≥ 200 mL 4.7% in continued APT vs 4.7% in discontinued APT vs 1.5% in control (P = 0.064)TE 0% in continued APT vs 0.9% in discontinued APT vs 0.2% in control (P = 0.296)
Patients with discontinuation of APT (n = 106)PBC 0% in continued APT vs 0.9% in discontinued APT vs 0.2% in control (P = 0.022)No mortality in any group
Patients not on APT (control, n = 653)
Yun[18]2017Laparoscopic cholecystectomy (elective vs emergency) for acute cholecystitisPatients with continued use of ATT (almost APT, n = 22)SBL ≥ 100mL 13.6% in continued ATT vs 22.2% in control (P = 0.613)One case of TE (2.2%) in control
Patients with discontinued ATT (almost APT, control, n = 45)Mortality 4.6% in continued ATT vs 2.2% in control (P > 0.999)
Laparoscopic appendectomy
Chechik[19]2011Appendectomy including laparoscopic appendectomy (n = 78)Patients with continued APT (n = 39)No difference in SBL or PBC between the groupsNo mortality in both groups
Patients without APT (control, n = 140)
Pearcy[20]2017Laparoscopic appendectomy (urgent only)Patients with continued APT (n = 287)No difference in SBL (31 g vs 26 g) or blood transfusion rate (1% vs 0%) between the groupsTwo cases of TE (MI) in continued APT (0.7%)
Matched patients without APT (control, n = 287)No difference in the rates of mortality (1% vs 0%, P = 0.12)