Study on the Changes in D-Dimer Levels in Patients Undergoing Laparoscopic Surgery with Pneumoperitoneum (Code: T0007)

Introduction: Laparoscopic surgery, which utilizes carbon dioxide (CO₂) pneumoperitoneum for abdominal cavity insufflation, has revolutionized minimally invasive surgery. However, the physiological and coagulation-related changes induced by pneumoperitoneum remain incompletely understood. D-dimer, a fibrin degradation product, is a key marker of coagulation activation and fibrinolysis. This study investigates the changes in D-dimer levels before and after laparoscopic surgery and examines the relationship between D-dimer elevation, surgery duration, and type.

AIMS AND OBJECTIVES

AIM :

To determine the changes in the d dimer values in a patient undergoing laparoscopic surgery using pneumoperitoneum.

OBJECTIVES OF THE STUDY :

1. To estimate the level of D Dimer pre operatively of a patient

undergoing laparoscopic surgery.

1. To estimate the level of D Dimer 6 hours after surgery in the

same patient after undergoing laparoscopic surgery.

1. To compare the pre operative and post operative D Dimer values

of the same patient undergoing laparoscopic surgery.

1. To determine the significant change in the D Dimer Values
2. To determine if there are any change in the D Dimer values

based on the change in time duration of the laparoscopic

Methods: A cross-sectional observational study was conducted with 36 patients undergoing laparoscopic cholecystectomy, appendectomy, or fundoplication at K.S. Hegde Charitable Hospital. Venous blood samples for D-dimer measurement were collected one hour before surgery and six hours after surgery. The type and duration of each surgical procedure were recorded, and statistical analysis was performed using paired t-tests and correlation coefficients.

Results: The mean preoperative D-dimer level was 0.32 ± 0.05 µg/ml, which significantly increased to 0.65 ± 0.03 µg/ml postoperatively (p<0.001). A positive correlation was observed between the duration of surgery and postoperative D-dimer elevation (p<0.001). D-dimer levels were significantly higher in longer surgeries, with notable variations observed across the different types of laparoscopic procedures.

Conclusion: Laparoscopic surgeries involving CO₂ pneumoperitoneum lead to a significant elevation in D-dimer levels, indicating activation of the coagulation cascade. Both the duration and type of laparoscopic procedure affect this increase. Monitoring D-dimer levels may be an effective approach for assessing thromboembolic risks and optimizing perioperative management.