Are Type and Screen Samples Routinely Necessary Before Laparoscopic Cholecystectomy?
- PDF / 265,944 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 54 Downloads / 200 Views
ORIGINAL ARTICLE
Are Type and Screen Samples Routinely Necessary Before Laparoscopic Cholecystectomy? M. L. Fong 1
&
D. Urriza Rodriguez 1 & H. Elberm 1 & D. P. Berry 1
Received: 8 October 2019 / Accepted: 3 January 2020 # 2020 The Society for Surgery of the Alimentary Tract
Abstract Aims Type and screen (T&S) samples are routinely requested before all laparoscopic cholecystectomies (LCs) at our centre despite the low reported risk of major vascular injury and peri-operative transfusion. Our retrospective case series aimed to identify local transfusion need to inform policy. Methods Emergency and elective LC performed at a single tertiary centre between March 2014 and October 2016 (30 months) were analysed. This included all patients aged ≥ 16, and procedures converted to open where LC was the primary procedure. Perioperative complications and transfusion data were obtained from electronic records. Results In total, 1002 consecutive patients met inclusion criteria; 12 patients were transfused during index admission (1.20%). No patients required emergency transfusion or had major vascular injuries. Despite local policy, 106 patients (10.6%) did not have a valid T&S sample prior to their procedure. Transfused patients were more likely to be emergency admissions (n = 10/12). The most common indications for transfusion were pre-operative anaemia (n = 7/12) and septic coagulopathy (n = 2/12). Conclusions Peri-operative transfusions at our centre were low. No patients required intra-operative blood transfusions dependent on a pre-operative T&S sample. Patients requiring transfusion were predictable from their pre-operative clinical status. We propose that a highly selective T&S policy is safe and can reduce costs. Keywords Laparoscopic cholecystectomy . Group and save . Type and screen . Pre-operative blood tests . Transfusion . Blood transfusion
Introduction Gallstones are common, with 10–15% of the UK population estimated to have them from ultrasound surveillance studies.1, 2 It is estimated that 25.8% develop symptomatic disease within 10 years.2 In appropriate patients, laparoscopic cholecystectomy (LC) is the gold standard definitive surgical
management and the National Health Service (NHS) performs about 60,000 annually.1 Current National Institute of Clinical Excellence (NICE) guidance on pre-operative tests excludes blood typing and deems this a clinical decision.3 On literature review, the authors found that both the reported risk of major vascular injury and peri-operative transfusion in LC is low. In studies over the last
Previous Communications Poster accepted and presented at ASGBI Conference 2017 (Glasgow) Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11605-020-04515-8) contains supplementary material, which is available to authorized users. * M. L. Fong [email protected] D. Urriza Rodriguez [email protected] H. Elberm [email protected]
D. P. Berry [email protected] 1
Department of Surgery, Southampton General Hospital
Data Loading...
Recommend Documents
Frailty predicts outcome of elective laparoscopic cholecystectomy in geriatric patients
149 70 244KB
Day case laparoscopic cholecystectomy at Kilimanjaro Christian Medical Centre, Tanzania
186 16 627KB
