Bleeding complications in cholecystectomy: a register study of over 22 000 cholecystectomies in Finland

Abstract

BackgroundMajor bleeding is rare but among the most serious complications of laparoscopic surgery. Still very little is known on bleeding complications and related blood component use in laparoscopic cholecystectomy (LC). The aim of this study is to compare bleeding complications, transfusion rates and related costs between LC and open cholecystectomy (OC).MethodsData concerning LCs and OCs and related blood component use between 2002 and 2007 were collected from existing computerized medical records (Finnish Red Cross Register) of ten Finnish hospital districts.ResultsRegister data included 17175 LCs and 4942 OCs. In the LC group, 1.3 % of the patients received red blood cell (RBC) transfusion compared to 13 % of the patients in the OC group (p < 0.001). Similarly, the proportions of patients with platelet (0.1 % vs. 1.2 %, p < 0.001) and fresh frozen plasma (FFP) products (0.5 % vs. 5.8 %) transfusions were respectively higher in the OC group than in the LC group. The mean transfused dose of RBCs, PTLs and FFP product Octaplas® or the mean cost of the transfused blood components did not differ significantly between the LC and OC groups.ConclusionsLaparoscopic cholecystectomy was associated with lower transfusion rates of blood components compared to open surgery. The severity of bleeding complications may not differ substantially between LC and OC.

Evaluation of the Bleeding Complications in Laparoscopic Cholecystectomy in a Tertiary Care Hospital: A Cross-Sectional Study

“…Bleeding in LC can be encountered intraoperatively or in the postoperative period. Intraoperative bleeding usually falls into one of the following four patterns: vessel injury, slippage of clips/ ligatures of the cystic artery, liver bed bleeding and miscellaneous [28]. However in our study in 44 (27%) patients were bleeding through gallbladder bed while in the study of Malik AM [29] reported in his study 11(1.05%) cases bleeding through gallbladder bed.…”

Laparoscopic cholecystectomy performed by general surgery residents. Is it safe? How much does it cost?

“…As for associated diseases, we opted for the use of SOI in the stratification of cases, since this score is what is usually reported in the literature [18][19][20] . The mean duration of our procedures was about 52 minutes, other works reporting values between 37 and 93 minutes in university hospitals [21][22][23][24][25][26][27][28] .…”

Morbimortalidad de la colecistectomía laparoscópica electiva en un servicio universitario

“…La CL no está exenta de riesgo de mortalidad vinculada al procedimiento. Pucher y colaboradores (3) reportan una mortalidad de 0,08%-0,14%, pero otros estudios reportan tasas de mortalidad hospitalaria de hasta 0,3%-0,7% (10,31) . Las causas de mortalidad pueden estar vinculadas a la inserción de trócares (lesión de grandes vasos, sepsis por lesión intestinal inadvertida), o a eventos intra o posoperatorios (lesión vascular del pedículo hepático, embolia gaseosa, descompensación cardiovascular, etc.).…”