جامعة الكوت - University of kut - بحوث

السنة	عنوان البحث	نشر البحث
202673	Effect of Cholecystectomy (Open & Laparoscopic) on Clotting Factor Synthesis in Liver	MEDICAL FORUM MONTHLY
Abstract One common surgery, cholecystectomy, causes a systemic inflammatory reaction that changes depending on the type of surgery (open vs. laparoscopic). According to Interleukin-6 (IL-6), this reaction starts an acute phase shift in the liver that may temporarily stop the production of vitamin K-dependent clotting factors. This can change the coagulation state after surgery. Fourty adults who had an open or laparoscopic cholecystectomy at Al-Zahraa Teaching Hospital in Iraq between February 2024 and July 2025 were part of this prospective comparative cohort study. Initial statistics showed that both groups were statistically similar (p > 0.05). Prior to and after surgery, blood samples were checked for Prothrombin Time (PT), International Normalized Ratio (INR), Fibrinogen, and plasma levels of Factor VII and Factor X. IL-6 was used as the main indicator of inflammation. When looking at the data, paired t-tests, independent t-tests for change-from- baseline values, Pearson association, and multiple linear regression were all used. Inflammation and blood clotting changed in both surgery groups, but the open cholecystectomy group had a much bigger reaction. The open group had a much higher postoperative rise in IL-6 (36.5 ± 12.0 pg/mL) than the laparoscopic group (16.4 ± 8.1 pg/mL; p < 0.001), which was accompanied by a stronger decrease in Factor VII (-12.0% ± 4.4%) and a more noticeable rise in INR (+0.24 ± 0.08 vs. +0.09 ± 0.06; p < 0.001). Differential regression showed that both surgery method and higher IL-6 levels were separate factors of Factor VII inhibition. This was true for all patients. While open cholecystectomy causes a stronger IL-6-mediated inflammatory response that temporarily lowers liver coagulation factor output, laparoscopic cholecystectomy greatly lessens this effect, keeping more stable clotting function after surgery.