Are blood group and save samples needed for cholecystectomy?

Abstract

The use of routine blood group and save is not justified. A targeted approach will reduce the demand on blood transfusion service without detriment to those undergoing cholecystectomy. There is no substitute for adequate vigilance for bleeding as a complication with any surgical procedure.

Establishing consensus on the perioperative management of cholecystectomy in public hospitals: a Delphi study with an expert panel in Mexico

“…Before cholecystectomy, the use of pre-transfusion testing is based on the possible need for emergency blood transfusion in cases of unexpected intraoperative or postoperative bleeding. The consensus agrees with most of the evidence showing that pre-transfusion tests are not currently required and that the use of these tests increases material and human costs 15 although the possibility of requiring an urgent transfusion after an elective procedure such as cholecystectomy is less than 2%. 16 Furthermore, in the rare cases when an urgent transfusion is needed in hemorrhagic situations, the risk of a transfusion reaction is very low when uncrossmatched type-O red cells are used.…”

Requirement of preoperative blood typing for cholecystectomy and appendectomy: a systematic review

“…All the abstracts were screened and 15 full-text articles [11,[19][20][21][22][23][24][25][26][27][28][29][30][31][32] strictly met the study inclusion criteria-a total of 477,437 patients. All were retrospective studies: 10 studies [11,19,21,23,[25][26][27][28][29][30] reviewed the necessity of G&S for cholecystectomy procedures only, two studies [31,32] on appendectomy procedures only and three studies [20,22,24] evaluated both procedures. A PRISMA [33] flowchart of the section process for this study is presented in Fig.…”

“…A summary of the reported patient and operative factors that may have contributed to perioperative blood transfusion, as well as the timing of transfusion in relation to the index procedure is shown in Table 3 . Of the 9807 (2.1%) patients who received a perioperative blood transfusion, information on risk factors and co-morbidities were reported in 45 patients [ 19 , 23 , 24 , 26 , 28 , 29 ]. The main preoperative indications for blood transfusion include cardiovascular co-morbidity 16/45 (35.6%), coagulopathy (including use of anticoagulants) 13/45 (28.9%), moderate anaemia (haemoglobin < 100 g/L) 9/45 (20.0%) and primary haematological malignancy 6/45 (13.3%).…”

“…Laparoscopic cholecystectomy was completed in at least 469,338 (98.9%) patients. Ten [11,20,21,23,[25][26][27][28][29][30][31] out of 13 studies recorded the number of patients that underwent preoperative G&S testing. Data was extractable in nine of these studies: a total of 177,178/468,981 (37.8%, range 8.5-100%) patients.…”

Minimising costs in spinal surgery: is group & save testing justified in lumbar decompression surgery?

“…Resistance to abandonment of these unnecessary procedures prior to surgery has been encountered in other specialties, despite good evidence to suggest the expenditure is necessary (12)(13)(14). This is probably due to concerns regarding catastrophic intra-operative blood loss in very rare circumstances.…”