HPB SO39 - Incidence for the need of blood transfusion for Laparoscopic Cholecystectomy :Is a group and save always needed ?

Abstract Background Major bleeding is rare but among the most serious complications of laparoscopic surgery. As low as 1.3% of patient undergoing laparoscopic cholecystectomy may require a blood transfusion. We propose that not all patients undergoing laparoscopic cholecystectomy require a valid group and save sample, as the risk of bleeding is minimal. Method Health records of 458 patients who underwent cholecystectomy at our two hospital sites were reviewed for blood transfusion up to 30 days post-operatively. This review included elective and emergency procedures from January 2023 till March 2024. Demographics and surgical outcomes, including preoperative Haemoglobin (Hb) levels, need for transfusion, reason for transfusion and amount of units transfused were recorded. We analysed nominal values in proportions and percentages. Results Average pre-operative Hb levels were 13.38 g/dl. 7 patients required peri-operative blood transfusion. Three patients requiring transfusion had conversion to open cholecystectomy. Three patients requiring transfusion underwent emergency procedures. Time to transfusion ranged from 2 hours-5 days. All patients requiring transfusion were at our main hospital site (Watford General Hospital). Our yearly cost of ordering routine group and save sample throughout the audit period was £12,824 Conclusion Routine group and save is not required prior to Laparoscopic Cholecystectomy. In case transfusion is required sufficient time to process a group and save samples is present. High risk patients i.e those with known haematological malignancies, coagulopathy, concurrent use of blood thinner, higher ASA grades can be identified and selective blood grouping performed.