Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Surgery
Published in: BMC Surgery 1/2015

Open Access 01-12-2015 | Research article

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

Authors: S. Suuronen, A. Kivivuori, J. Tuimala, H. Paajanen

Published in: BMC Surgery | Issue 1/2015

Login to get access

Abstract

Background

Major 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).

Methods

Data 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.

Results

Register 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.

Conclusions

Laparoscopic 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.
Literature
1.
Barkun JS, Barkun AN, Meakins JL. Laparoscopic versus open cholecystectomy: The Canadian experience. The McGill Gallstone Treatment Group. Am J Surg. 1993;165:455–8.CrossRefPubMed
2.
Dolan JP, Diggs BS, Sheppard BC, Hunter JG. The national mortality burden and significant factors associated with open and laparoscopic cholecystectomy: 1997–2006. J Gastrointest Surg. 2009;13:2292–301.CrossRefPubMed
3.
Keus F, de Jong JAF, Gooszen HG, van Laarhoven CJHM. Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev. 2006;4(4):CD006231.
4.
Roslyn JJ, Binns GS, Hughes EF, Saunders-Kirkwood K, Zinner MJ, Cates JA. Open cholecystectomy. A contemporary analysis of 42,474 patients. Ann Surg. 1993;218:129–37.CrossRefPubMedPubMedCentral
5.
Nuzzo G, Giuliante F, Giovannini I, Ardito F, D’Acapito F, Vellone M, et al. Bile duct injury during laparoscopic cholecystectomy: results of an Italian national survey on 56 591 cholecystectomies. Arch Surg. 2005;140:986–92.CrossRefPubMed
6.
Fletcher DR, Hobbs MS, Tan P, Valinsky LJ, Hockey RL, Pikora TJ, et al. Complications of cholecystectomy: risks of the laparoscopic approach and protective effects of operative cholangiography: a population-based study. Ann Surg. 1999;229:449–57.CrossRefPubMedPubMedCentral
7.
Saia M, Mantoan D, Buja A, Bertoncello C, Baldovin T, Callegaro G, et al. Time trend and variability of open versus laparoscopic cholecystectomy in patients with symptomatic gallstone disease. Surg Endosc. 2013;27:3254–61.CrossRefPubMed
8.
Rosenmüller M, Haapamäki MM, Nordin P, Stenlund H, Nilsson E. Cholecystectomy in Sweden 2000–2003: a nationwide study on procedures, patient characteristics, and mortality. BMC Gastroenterol. 2007;7:35.CrossRefPubMedPubMedCentral
9.
Z’graggen K, Wehrli H, Metzger A, Buehler M, Frei E, Klaiber C. Complications of laparoscopic cholecystectomy in Switzerland. A prospective 3-year study of 10,174 patients. Swiss Association of Laparoscopic and Thoracoscopic Surgery. Surg Endosc. 1998;12:1303–10.CrossRefPubMed
10.
Bingener-Casey J, Richards ML, Strodel WE, Schwesinger WH, Sirinek KR. Reasons for conversion from laparoscopic to open cholecystectomy: a 10-year review. J Gastrointest Surg. 2002;6:800–5.CrossRefPubMed
11.
Ballal M, David G, Willmott S, Corless DJ, Deakin M, Slavin JP. Conversion after laparoscopic cholecystectomy in England. Surg Endosc. 2009;23:2338–44.CrossRefPubMed
12.
Harboe KM, Bardram L. The quality of cholecystectomy in Denmark: outcome and risk factors for 20,307 patients from the national database. Surg Endosc. 2011;25:1630–41.CrossRefPubMed
13.
Huang X, Feng Y, Huang Z. Complications of laparoscopic cholecystectomy in China: an analysis of 39,238 cases. Chin Med J (Engl). 1997;110:704–6.
14.
Schäfer M, Lauper M, Krähenbühl L. A Nation’ s experience of bleeding complications during laparoscopy. Am J Surg. 2000;180:73–7.CrossRefPubMed
15.
Opitz I, Gantert W, Giger U, Kocher T, Krähenbühl L. Bleeding remains a major complication during laparoscopic surgery: analysis of the SALTS database. Langenbecks Arch Surg. 2005;390:128–33.CrossRefPubMed
16.
Shea J a, Healey MJ, Berlin J a, Clarke JR, Malet PF, Staroscik RN, et al. Mortality and complications associated with laparoscopic cholecystectomy. Ann Surg. 1996;224:609–20.CrossRefPubMedPubMedCentral
17.
Lengyel BI, Azagury D, Varban O, Panizales MT, Steinberg J, Brooks DC, et al. Laparoscopic cholecystectomy after a quarter century: why do we still convert? Surg Endosc. 2012;26:508–13.CrossRefPubMed
18.
Palo R, Ali-Melkkilä T, Hanhela R, Jäntti V, Krusius T, Leppänen E, et al. Development of permanent national register of blood component use utilizing electronic hospital information systems. Vox Sang. 2006;91:140–7.CrossRefPubMed
19.
Capraro L, Nuutinen L, Myllyla G. Transfusion thresholds in common elective surgical procedures in Finland. Vox Sang. 2000;78:96–100.CrossRefPubMed
20.
Palo R, Capraro L, Hanhela R, Koivuranta M, Nikkinen L, Salmenperä M, et al. Platelet transfusions in adult patients with particular reference to patients undergoing surgery. Transfus Med. 2010;20:30–7.CrossRefPubMed
21.
Palo R, Capraro L, Hovilehto S, Koivuranta M, Krusius T, Loponen E, et al. Population-based audit of fresh-frozen plasma transfusion practices. Transfusion. 2006;46:1921–5.CrossRefPubMed
22.
Suuronen S, Niskanen L, Paajanen P, Paajanen H. Declining cholecystectomy rate during the era of statin use in Finland: a population-based cohort study between 1995 and 2009. Scand J Surg. 2013;102:158–63.CrossRefPubMed
23.
Suuronen S, Koski A, Nordstrom P, Miettinen P, Paajanen H. Laparoscopic and open cholecystectomy in surgical training. Dig Surg. 2010;27:384–90.CrossRefPubMed
24.
Ercan M, Bostanci EB, Ozer I, Ulas M, Ozogul YB, Teke Z, et al. Postoperative hemorrhagic complications after elective laparoscopic cholecystectomy in patients receiving long-term anticoagulant therapy. Langenbecks Arch Surg. 2010;395:247–53.CrossRefPubMed
25.
Persson G, Strömberg J, Svennblad B, Sandblom G. Risk of bleeding associated with use of systemic thromboembolic prophylaxis during laparoscopic cholecystectomy. Br J Surg. 2012;99:979–86.CrossRefPubMed
26.
Joseph B, Rawashdeh B, Aziz H, Kulvatunyou N, Pandit V, Jehangir Q, et al. An acute care surgery dilemma: emergent laparoscopic cholecystectomy in patients on aspirin therapy. Am J Surg. 2015;209:689–94.CrossRefPubMed
Metadata
Title
Bleeding complications in cholecystectomy: a register study of over 22 000 cholecystectomies in Finland
Authors
S. Suuronen
A. Kivivuori
J. Tuimala
H. Paajanen
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2015
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-015-0085-2

Other articles of this Issue 1/2015

BMC Surgery 1/2015 Go to the issue

Research article

Neuroendocrine tumors of the pancreas: a retrospective single-center analysis using the ENETS TNM-classification and immunohistochemical markers for risk stratification

Research article

Combined anterior lumbar interbody fusion and instrumented posterolateral fusion for degenerative lumbar scoliosis: indication and surgical outcomes

Research article

Long-term outcome after bilateral lung transplantation – a retrospective study from a low-volume center experience

Research article

Enhanced recovery after surgery (ERAS) protocols for colorectal cancer in Japan

Research article

Laparoscopic transperitoneal lateral adrenalectomy for malignant and potentially malignant adrenal tumours

Research article

Tumor regression and survival after perioperative MAGIC-style chemotherapy in carcinoma of the stomach and gastroesophageal junction