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Langenbeck's Archives of Surgery

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01-05-2015 | Original Article

Incidence and risk factors for symptomatic venous thromboembolism following cholecystectomy

Authors: J. Strömberg, O. Sadr-Azodi, P. Videhult, F. Hammarqvist, G. Sandblom

Published in: Langenbeck's Archives of Surgery | Issue 4/2015

Abstract

Background

The benefit of thromboembolism prophylaxis in cholecystectomy is controversial. This population-based study report on the incidence of and risk factors for symptomatic venous thromboembolism (VTE) after cholecystectomy.

Method

All cholecystectomies registered in the Swedish Register of Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks) between 2006 and 2011 were reviewed. By linking patient data to the Swedish National Patient Register (NPR), the 30-day postoperative incidence of VTE (deep venous thrombosis [DVT] and/or pulmonary embolism [PE]) was identified. Age- and gender-standardized incidence ratio (SIR) for deep venous thrombosis (DVT) and pulmonary embolism (PE) were calculated. Multivariable analysis determined risk factors for VTE by calculating odds ratio (OR).

Results

Altogether 62,488 procedures were registered and postoperative VTE was seen in 154 (0.25 %) patients. DVT was seen in 36 (0.06 %) patients and PE in 25 (0.04 %) patients within 30 days after surgery. The SIR for DVT was 22.2 (95 % confidence interval (CI) 13.1–31.3) and for PE 5.6 (95 % CI 2.3–8.9). Risk factors for VTE within 30 days after cholecystectomy were age >70 years (odds ratio [OR] = 2.69; 95 % confidence interval [CI] 1.68–4.30), open cholecystectomy (OR = 1.95; CI 1.31–2.92), operation time >120 min (OR = 1.66; CI 1.18–2.35), acute cholecystitis (OR = 1.69; CI 1.18–2.42), and previous history of VTE (OR = 50.5; CI 27.3–92.8). Thromboembolism prophylaxis (TP) increased the risk for postoperative bleeding (OR = 1.72; 1.44–2.05).

Conclusion

The incidence of VTE after cholecystectomy is low and thromboembolism prophylaxis (TP) increases the risk for postoperative bleeding. Patients with previous VTE events should be given TP when undergoing cholecystectomy.

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Title: Incidence and risk factors for symptomatic venous thromboembolism following cholecystectomy
Authors: J. Strömberg
O. Sadr-Azodi
P. Videhult
F. Hammarqvist
G. Sandblom
Publication date: 01-05-2015
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 4/2015
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-015-1284-0

At a glance: The STEP trials

Springer Medicine

Incidence and risk factors for symptomatic venous thromboembolism following cholecystectomy

Abstract

Background

Method

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Method

Results

Conclusion

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