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A case report and literature review of perioperative management of laparoscopic cholecystectomy in patients with hemophilia |
ZHOU Zheyu1 WANG Kai2 LIU Qiaoyu3 YIN Yin3 |
1.Department of General Surgery, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Jiangsu Province, Nanjing 210008, China; 2.Nanjing Drum Tower Clinical Medical College, Nanjing University of Chinese Medicine, Jiangsu Province, Nanjing 210008, China; 3.Department of Hepatobiliary Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Province, Nanjing 210008, China |
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Abstract Hemophilia C (factor Ⅺ deficiency) is a rare coagulation dysfunction disorder. Spontaneous bleeding is rare in patients with hemophilia C, and significant bleeding usually occurs after trauma or surgical procedures. According to the literature review, there have been no reports of patients with hemophilia C undergoing laparoscopic cholecystectomy. The patient sought medical treatment due to “gallstone discovery for more than four years and intermittent dull pain in the abdomen for more than ten months”, and had a previous history of hemophilia C. Preoperative coagulation function examination showed that the activated partial thromboplastin time was significantly prolonged (67.4 s), and the factor Ⅺ activity was 2.4%. According to the consultation of hematology department, the patient was treated with fresh frozen plasma and tranexamic acid in perioperative period. In the end, the operation was successful, and there was no obvious bleeding during and after the operation. This case report suggests that it is safe for hemophilia C patients to receive laparoscopic cholecystectomy after symptomatic treatment, and can provide reference for clinical diagnosis and treatment of similar cases.
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