{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T13:45:02Z","timestamp":1758635102196},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,11,20]],"date-time":"2018-11-20T00:00:00Z","timestamp":1542672000000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The risk of developing hemorrhagic complications during or after emergency cholecystectomy in patients with antithrombic therapy (<jats:styled-content style=\"fixed-case\">ATT<\/jats:styled-content>) remains uncertain. In this study, we evaluate outcomes in patients with <jats:styled-content style=\"fixed-case\">ATT<\/jats:styled-content> undergoing emergency cholecystectomy and assess the relevance between <jats:styled-content style=\"fixed-case\">ATT<\/jats:styled-content> and perioperative complications including bleeding complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively evaluated 296 patients who were diagnosed as acute cholecystitis and underwent emergency cholecystectomy between 2005 and 2017. One hundred and thirty\u2010three of them (45%) were on <jats:styled-content style=\"fixed-case\">ATT<\/jats:styled-content>. The primary outcome measures were intraoperative blood loss over 500\u00a0ml and postoperative complications including bleeding complications. This study was approved by our institutional review board (#13072904).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 23 patients (8%) who experienced intraoperative blood loss over 500\u00a0ml and nine postoperative bleeding complications (3%). Multivariable analyses showed that male sex (<jats:italic>P<\/jats:italic> = 0.027), Performance Status 2\u20134 (<jats:italic>P<\/jats:italic> = 0.031) and grade <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> acute cholecystitis (<jats:italic>P<\/jats:italic> = 0.033) were independent risk factors for intraoperative bleeding over 500\u00a0ml, whereas not single antiplatelet therapy (<jats:styled-content style=\"fixed-case\">APT<\/jats:styled-content>) use but multiple <jats:styled-content style=\"fixed-case\">APT<\/jats:styled-content> (<jats:italic>P<\/jats:italic> = 0.034) and anticoagulation therapy (ACT) (<jats:italic>P<\/jats:italic> = 0.032) were independently associated with postoperative bleeding complications. Additionally, laparoscopic surgery, but not <jats:styled-content style=\"fixed-case\">ATT<\/jats:styled-content>, was a significant prognostic factor for severe postoperative complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Single <jats:styled-content style=\"fixed-case\">APT<\/jats:styled-content> was not remained as an independently associated factor of intraoperative excessive bleeding or severe postoperative complications including bleeding complications. However, patients treated with multiple <jats:styled-content style=\"fixed-case\">APT<\/jats:styled-content> or ACT still represent a challenging group and must be carefully managed to avoid postoperative bleeding complications.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.588","type":"journal-article","created":{"date-parts":[[2018,10,12]],"date-time":"2018-10-12T16:14:18Z","timestamp":1539360858000},"page":"518-526","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Effect of antithrombic therapy on bleeding complications in patients receiving emergency cholecystectomy for acute cholecystitis"],"prefix":"10.1002","volume":"25","author":[{"given":"Yusuke","family":"Kawamoto","sequence":"first","affiliation":[{"name":"Department of Surgery Kokura Memorial Hospital Fukuoka 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