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The aim of this study was to investigate the effects of treatment dose low-molecular-weight heparin (LMWH) on bleeding in a laparoscopic cholecystectomy (LC). Materials and Methods: The data of patients who underwent an elective LC in the clinic between January 2013 and May 2017 were retrospectively evaluated. The patients were divided into 3 groups. Group I comprised patients who were not on any anticoagulant or antiaggregant agent, Group II included patients who were taking an oral anticoagulant (OAC), and Group III was made up of patients who were on antiaggregant agents (aspirin and/or clopidogrel). The basic clinical and laboratory characteristics of the groups and the data on the surgery and complications were recorded and compared. Factors affecting major bleeding were analyzed through univariate and multivariate analysis. Results: There were 285 (80.7%) patients in Group I, while there were 30 (8.4%) patients on an OAC in Group II, and 38 (10.7%) patients taking antiaggregants in Group III. Major bleeding was seen in 1 patient in Group I and in Group III (0.3%, 2.6% respectively), while major bleeding necessitating transfusion was seen in 5 (16.6%) patients on an OAC in Group II (p<0.001). The results of univariate analysis revealed that age ≥65 years, American Society of Anesthesiologists score ≥3, body mass index ≥25 kg/m2, international normalized ratio ≥1.2, PTZ ≥14 seconds, administration of treatment dose LMWH (twice daily), and operation time ≥60 minutes were factors that affected bleeding. The results of multivariate logistic regression analysis, however, showed that only treatment dose LMWH administration was an independent risk factor affecting major bleeding (p=0.021; odds ratio (OR): 14.49, confidence interval [CI]: 0.007–0.666). Conclusion: Bridging treatment with LMWH and interrupting OAC treatment increases the risk of major bleeding in LC. Offering patient-based bridging treatment for patients receiving long-term OAC in surgical practice and avoiding aggressive perioperative prophylaxis will reduce the risk of postoperative major bleeding.

The effects of low-molecular-weight-heparin administration on bleeding in elective laparoscopic cholecystectomy