期刊论文详细信息
BMC Surgery
Bleeding complications in cholecystectomy: a register study of over 22 000 cholecystectomies in Finland
H. Paajanen2  J. Tuimala1  A. Kivivuori3  S. Suuronen3 
[1] Finnish Red Cross Blood Service, Helsinki, 00100, Finland;School of Medicine, University of Eastern Finland, Kuopio, 70600, Finland;Department of Surgery, Mikkeli Central Hospital, Mikkeli, 50100, Finland
关键词: Bleeding complication;    Open cholecystectomy;    Laparoscopic cholecystectomy;   
Others  :  1222713
DOI  :  10.1186/s12893-015-0085-2
 received in 2015-03-02, accepted in 2015-08-04,  发布年份 2015
【 摘 要 】

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.

【 授权许可】

   
2015 Suuronen et al.

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【 参考文献 】
  • [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.
  • [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.
  • [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.
  • [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.
  • [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.
  • [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.
  • [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. BioMed Central Full Text
  • [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.
  • [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.
  • [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.
  • [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.
  • [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.
  • [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.
  • [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.
  • [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.
  • [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.
  • [19]Capraro L, Nuutinen L, Myllyla G. Transfusion thresholds in common elective surgical procedures in Finland. Vox Sang. 2000; 78:96-100.
  • [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.
  • [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.
  • [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.
  • [23]Suuronen S, Koski A, Nordstrom P, Miettinen P, Paajanen H. Laparoscopic and open cholecystectomy in surgical training. Dig Surg. 2010; 27:384-90.
  • [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.
  • [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.
  • [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.
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