76 Group and Save for Laparoscopic Cholecystectomy: A Snapshot Cohort Study

Abstract Aim Group and Save (G&S) are routinely collected for laparoscopic cholecystectomy (LC). GGC South mandates G&S for all LC. NICE guideline NG45 does not provide guidance on G&S in its perioperative management. The primary aim of this study is to investigate the necessity of routine G&S for patients undergoing LC and secondary aim is to determine its cost effectiveness. Method Data for elective and emergency LC from March 2023 to March 2024 was retrospectively collected. Admission type, anticoagulation status, peri-operative bleeding and transfusion records were investigated using Clinical Portal. Intra-operative bleeding was defined by documented bleeding requiring more than standard diathermy or instructions to withhold post- operative clexane. Cost of performing blood grouping were sourced from transfusion department. Results A total of 363 LC were performed. 3 patients excluded from analysis as LC were performed as part of another operation. Of the 360 cases, 251 were emergency LC and 109 elective LC. 3 elective patients did not have G&S and no patients from this group required transfusion. Subgroup investigation shown 4 patients in the emergency group had received blood products. 1 patient had laparotomy at day 4, 1 had FFP pre-op in ITU and 1 had delayed bleeding at day 10. Only 1 patient with liver cirrhosis needed intra-operative transfusion (0.2%). The average cost of G&S for one case was 40£. Conclusions We propose that routine G&S is not mandatory for LC as its both costly and should tailor to individual case.