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Goodwill and other intangible assets - Goodwill (Detail) - USD ($)
$ in Millions
 9 Months Ended 12 Months Ended
Sep. 30, 2025
Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]    
Balance at the beginning of the year [1] $ 83,880 $ 84,626
Business acquisitions 400 87
Other, including foreign currency translation 245 (833)
Balance at the end of the period [1] $ 84,525 $ 83,880
[1] Net of accumulated goodwill impairments of $11.5 billion as of September 30, 2025 and December 31, 2024 and $11.1 billion as of December 31, 2023.