PREVENTION OF THROMBOEMBOLIC COMPLICATIONS IN LAPAROSCOPIC SURGERY Sunita Ćustendil Delić, Sabina Nuhbegović, Šefik Hasukić, Farid Ljuca, Aida Žabić, Ahida Suljkanović Mahmutović, Svetlana Jović

Introduction: Hemostasis is a very important mechanism, whose changes may cause various complications. In the course of surgical interventions some changes in the system of coagulation occur. Laparoscopic cholecystectomy is the method of choice in the treatment of gall-bladder calculosis. In the course of the procedure, the parameters of hemostasis change, and this leads to the possible appearance of thromboembolic complications. The aim of the study was to reveal the changes in the system of coagulation in patients treated by laparoscopic cholecystectomy. Patients and methods: The study included a total of 60 patients, divided into two groups, who were treated either by the classical or the laparoscopic method. The parameters of primary and secondary hemostasis were determined for the patients of both groups at the Polyclinic for Transfusiology, UCC Tuzla, before and during the operation and 24 hours and on the 5th day after the surgery. Results: The changes were more expressed in the group of the patients treated by laparoscopic cholecystectomy. A very important result was the increased value of D-dimer measured on the 5th day after the operation in the patients operated by laparoscopic cholecystectomy, whose value was 2.5 times higher in relation to the preoperative value (263.5 µg/l, so it was beyond the limits of the reference values). Conclusion: Our results suggest that there is increased fibrinolytic activity after laparoscop ic cholecystectomy, which demands more detailed and complete study on thromboembolism prophylaxis.