Document Detail


Evaluation of hemostatic factors in patients undergoing major hepatic resection and other major abdominal surgeries.
MedLine Citation:
PMID:  21944629     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The aim of this study was to evaluate the role for additional testing of coagulation in perioperative management of patients undergoing major hepatic resection. Major outcome measures were perioperative measurements of hemostatic factors (activated partial prothrombin time [aPTT], prothrombin time/international normalized ratio, fibrinogen, antithrombin-III). We conducted a prospective, single-blind study comparing hemostatic factors in patients undergoing major hepatectomy, Whipple procedures, and other gastrointestinal operations. Ninety-five consecutive patients were enrolled. No values differed significantly at baseline. Immediately postoperative, only international normalized ratio was significantly lower comparing major hepatectomy with Whipple (P < 0.005) and other procedures (P < 0.0032). Twenty-four hours postoperative, antithrombin-III was lower for major hepatectomy than Whipple (P < 0.028) and others (P < 0.0001); fibrinogen was lower compared with Whipple (P < 0.014) and others (P < 0.0009); international normalized ratio was lower to compared with Whipple (P < 0.0001) and others (P < 0.0001). aPTT measurements never differed significantly between groups at any time. Antithrombin-III and fibrinogen only correlated with international normalized ratio and aPTT for the other procedures. Additional hemostatic values beyond the standard evaluations of aPTT and international normalized ratio are needed to better assess patients undergoing major hepatic surgery.
Authors:
Elliot B Tapper; Ken A Tanaka; Juan M Sarmiento
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  77     ISSN:  1555-9823     ISO Abbreviation:  Am Surg     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1188-93     Citation Subset:  IM    
Affiliation:
Anesthesia and.
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