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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2012 December;25(6):445-8
Hepatic subcapsular hematoma following cholecystectomy in patients under anticoagulation/antiaggregation therapy: shall we prefer thrombosis prophylaxis or hemorrhagic prevention?
Occhionorelli S., Gianesini S., Lupi L., Cappellari L., Stano R., Gennari S., Vasquez G.
Emergency Surgery Service, Sant’Anna Hospital, Ferrara, Italy
Nowadays, a relevant percentage of patients undergoing general surgery procedures presents a history of antiplatelets/anticoagulant therapy administration. A detailed and in-depth literature analysis of the hemorrhagic collateral effects linked to the thrombosis prophylaxis is lacking in this kind of surgical patients. A pertinent literature review, together with the possible diagnostic-therapeutic approaches, are discussed. We herein report three cases of intrahepatic subcapsular hematoma following either laparoscopic or open cholecystectomies in patients undergoing antiplatelets/anticoagulant therapy. Intrahepatic subcapsular hematoma is a rare but life-threatening and not predictable complication, which can be easily misdiagnosed if not suspected. The present topic highlights the need for further statistically significant investigations, concerning the everyday surgical dilemma of choosing between thrombosis prophylaxis and hemorrhagic risk.