Intraoperative Bleeding Complications Leading to Blood Transfusions (BloTs) in 17,412 Cholecystectomies in Finland: A...

Area of Science:

• Surgical outcomes research
• Geriatric surgery
• Hepatobiliary disease management

Background:

• Cholelithiasis (Chole) is a prevalent condition requiring surgical intervention globally.
• Limited research exists on intraoperative bleeding (IOB) complications and blood transfusions (BloTs) in elderly patients undergoing cholecystectomy (Ccy).

Purpose of the Study:

• To assess the incidence of IOB complications and the need for BloTs in elderly patients undergoing Ccy.
• To compare these outcomes between elderly (≥75 years) and younger (<75 years) Ccy patient cohorts.

Main Methods:

• A retrospective analysis of 17,412 patients who underwent Ccy.
• Stratification of patients based on age (≥75 years vs. <75 years) and surgical approach (emergency/open vs. elective/laparoscopic).
• Comparison of red blood cell BloT administration rates between age groups and surgical indications.

Main Results:

• 11% of Ccy patients (1,856/17,412) were aged ≥75 years.
• Elderly Ccy patients were more likely to undergo emergency or open procedures.
• Red blood cell BloTs were administered five times more frequently to patients ≥75 years (13%) compared to those <75 years (2.6%, p<0.001).
• The need for BloTs in emergency Ccys was four times higher in patients ≥75 years (5.5%) versus <75 years (1.3%, p<0.001).

Conclusions:

• Elderly patients with cholelithiasis have an elevated risk of perioperative intraoperative bleeding complications.
• Older adults undergoing cholecystectomy are significantly more likely to require blood transfusions.
• These findings underscore the need for careful perioperative management in elderly patients undergoing cholecystectomy.