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Routine preoperative blood group and save testing is Unnecessary for elective laparoscopic Cholecystectomy.

Ashutosh Tandon1, Kashif Shahzad1, Quentin Nunes1

  • 1Department of General Surgery, Aintree University Hospital NHS Foundation Trust, University of Liverpool, L9 7AL, Liverpool, UK.

Journal of Ayub Medical College, Abbottabad : JAMC
|October 28, 2017
PubMed
Summary

Routine preoperative blood typing for elective laparoscopic cholecystectomy is unnecessary. The study found a low transfusion rate (1:200), indicating that blood group and save testing does not improve patient outcomes for this procedure.

Keywords:
Cholecystolithiasisblood groupblood transfusionlaparoscopic cholecystectomy

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Area of Science:

  • Surgical Oncology
  • Transfusion Medicine
  • Evidence-Based Medicine

Background:

  • Preoperative ABO group and Rh(D) type testing for elective cholecystectomy lacks evidence-based support.
  • Historical practices often precede modern clinical evidence.

Purpose of the Study:

  • To evaluate the necessity of preoperative blood group and save testing for elective laparoscopic cholecystectomy.
  • To assess the incidence of perioperative blood transfusions in this patient cohort.

Main Methods:

  • Retrospective study of 2,079 adult patients undergoing elective laparoscopic cholecystectomy.
  • Analysis of blood transfusion rates and testing practices between January 2010 and October 2014.
  • Inclusion of data from eight additional studies for comparative analysis.

Main Results:

  • Preoperative testing was performed in 43.6% of patients; cross-matching in 3.1%.
  • No intraoperative transfusions were required; 0.58% received postoperative transfusions, primarily for severe bleeding (0.48%).
  • No patient deaths were recorded.

Conclusions:

  • The risk of blood transfusion for elective laparoscopic cholecystectomy is low (1:200).
  • Routine preoperative blood group and save testing is not indicated.
  • Testing does not alter management of hypovolemia or improve outcomes.