Emergent laparoscopic cholecystectomy is safe in the setting of hereditary coagulation disorders: a propensity score-matched analysis of the Nationwide Readmissions Database.

Background: Hereditary coagulation disorders (HCDs), including hemophilia and von Willebrand disease (VWD), are associated with an increased risk of perioperative bleeding. However, despite advances in medical management, the outcomes after routine procedures, such as laparoscopic cholecystectomy, in this population remain insufficiently characterized. This study aimed to evaluate the outcomes and readmissions of patients with HCDs after laparoscopic cholecystectomy.

Methods: The National Readmission Database was retrospectively analyzed for admissions from 2016 to 2022. Participants who underwent laparoscopic cholecystectomy for cholecystitis were identified and categorized according to the presence or absence of HCDs, defined as hereditary hemophilia or hereditary VWD. Propensity score matching (1:1) was used to identify comparable cohorts. The primary outcomes included composite bleed complications. The secondary outcomes included mortality, length of stay, discharge disposition, hospital costs, and other complications.

Results: Of the 909,982 weighted cases, 1166 (0.1%) involved patients with HCDs. After matching, 1170 participants without HCDs were compared with those with the condition. The rates of composite bleeding complications did not differ significantly between the HCD and control cohorts (2.4% vs 1.5%, respectively; P =.261). No significant differences in mortality, overall complications, length of stay, discharge disposition, or 30-day readmissions were observed. Readmissions due to bleeding were rare and did not differ significantly. Multivariate regression analysis showed no increased odds of bleeding complications (odds ratio [OR], 1.45 [95% CI, 0.64-3.32]; P =.372), all complications (OR, 1.07 [95% CI, 0.71-1.62]; P =.745), or 30-day readmissions (OR, 0.70 [95% CI, 0.45-1.09]; P =.118).

Conclusion: This retrospective, propensity-matched national database analysis suggests that laparoscopic cholecystectomy is safe for patients with HCDs.