Laparoscopic Cholecystectomy in a Hemophiliac Patient with Factor VIII Inhibitor.
- Author:
Hyun Ho CHOI
1
;
Han Jung CHANG
;
Woo Jung LEE
;
Byong Ro KIM
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. wjlee@yumc.yonsei.ac.kr
- Publication Type:Case Report
- Keywords:
Hemophilia A;
Factor VIII inhibitor;
FEIBA;
Novo-VII
- MeSH:
Cholecystectomy, Laparoscopic*;
Cholecystitis, Acute;
Factor VIII*;
Hemophilia A;
Hemorrhage;
Hemostasis;
Humans;
Phospholipids;
Prothrombin;
Thromboplastin
- From:Journal of the Korean Surgical Society
2005;69(6):488-492
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Hemophilia A is a severe bleeding disorder resulting from the lack of functional blood coagulation factor VIII. Accordingly, operations on patients with hemophilia A, except in a few cases, are performed with the administration of factor VIII. However, in those hemophilia A patients administered factor VIII inhibitor, factor VIII replacement therapy is ineffective. The treatment of hemophilic patients with factor VIII inhibitor is undertaken to utilize the hemostatic capacity of the activated forms of FVII, FIX and FX contained within prothrombin complex concentrates, which are purposely manufactured to contain Factor Eight Inhibitor Bypassing Activity (FEIBA) during surgery. Further, in the last few years, a new product, recombinant activated FVII (FVIIa, Novo-VII), which is thought to ensure hemostasis by binding, directly or in complex with tissue factor, to negatively charged phospholipids on the surface of activated platelets, has been licensed. Recently, we experienced a GB stone, with acute cholecystitis, in a fifty year old hemophilia A man treated with factor VIII inhibitor. Under medication with FEIBA and Novo-VII, a laparoscopic cholecystectomy was performed. Here, this case is reported, with a review of the literature.
