Bleeding complications in cholecystectomy: a register study of over 22,000 cholecystectomies in Finland.
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.
Department of Surgery, Mikkeli Central Hospital, 50100, Mikkeli, Finland.
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Suuronen
Department of Surgery, Mikkeli Central Hospital, 50100, Mikkeli, Finland.
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Kivivuori
Finnish Red Cross Blood Service, 00100, Helsinki, Finland.
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Tuimala
Department of Surgery, Kuopio University Hospital, PL 1777, 70600, Kuopio, Finland. Hannu.paajanen@kuh.fi.|School of Medicine, University of Eastern Finland, 70600, Kuopio, Finland. Hannu.paajanen@kuh.fi.
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Paajanen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D002763:Cholecystectomy / Q000009:adverse effects* / Q000191:economics; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000191:economics; D003365:Costs and Cost Analysis; D005260:Female; D005387:Finland; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000628:therapy; D055815:Young Adult