ROUTINE PREOPERATIVE BLOOD GROUP AND SAVE TESTING IS UNNECESSARY FOR ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY

Authors

  • Ashutosh Tandon University Hospital Aintree, Liverpool, UK
  • Khalid Shahzad University Hospital Aintree, Liverpool, UK
  • Quentin Nunes University Hospital Aintree, Liverpool, UK
  • Milind Shrotri University Hospital Aintree, Liverpool, UK
  • Raimundas Lunevicius University Hospital Aintree, Liverpool, UK

Abstract

Background: Although the practice of preoperative testing of ABO group and Rh (D) type for elective cholecystectomy has deep historical roots, it is not evidence-based. We aimed to assess the preoperative blood group and save testing practice for a cohort of patients subjected to elective laparoscopic cholecystectomy for symptomatic cholecystolithiasis between January 2010 and October 2014. Methods: National Health Service (NHS) hospital based, surgical procedure-specific, retrospective study was conducted. A final group consisted of 2,079 adult patients. We estimated the incidence of perioperative blood transfusion attributable to laparoscopic cholecystectomy. The results of eight other studies are presented. Results: A preoperative blood group and save test was performed in 907 patients (43.6%), whereas cross-matching was documented in 28 patients (3.1%). None required an intraoperative blood transfusion. Twelve patients (0.58%) underwent blood transfusion postoperatively following laparoscopic cholecystectomy, of which ten were transfused due to severe intra-abdominal bleeding (0.48%). There were no deaths. Conclusions: The likelihood of blood transfusion attributable to elective laparoscopic cholecystectomy is 1:200. A routine preoperative blood group and save testing is unnecessary. It neither alters the management of severe hypovolemia, secondary to perioperative bleeding, nor does it lead to better outcomes.Keywords: Cholecystolithiasis; laparoscopic cholecystectomy; blood group; blood transfusion

Author Biographies

Ashutosh Tandon, University Hospital Aintree, Liverpool, UK

Specialist Registrar

Khalid Shahzad, University Hospital Aintree, Liverpool, UK

Consultant Surgeon

Quentin Nunes, University Hospital Aintree, Liverpool, UK

Specialist Registrar

Milind Shrotri, University Hospital Aintree, Liverpool, UK

Consultant Surgeon

Raimundas Lunevicius, University Hospital Aintree, Liverpool, UK

Consultant Surgeon

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Published

2017-07-11