OGBN P16 Pre-operative group and save, is there still a need in the elective and emergency laparoscopic cholecystectomy?


 
 
 Laparoscopic cholecystectomy is associated with a high safety profile. This study aimed to quantify the rate of blood transfusion in the elective and emergency setting and explore patient outcome and selection for Group and Save (G&S) sampling.
 
 
 
 A retrospective observational study investigating patients who underwent an elective or emergency laparoscopic cholecystectomy at a single Trust in the UK, between December 2019 and May 2021. Outcomes of interest were selected based on their clinical possibility of being influenced by the number of pre-operative G&S samples using multivariate logistic regression models.
 
 
 
 There were 959 patients; 631 (65.8%) elective and 328 (34.2%) emergency cholecystectomies. Median age was 48 (35–59) years, and 724 (75.5%) patients were female. Five patients (0.5%) needed blood transfusion post-operatively, with an average time of six hours. Three of these patients had haematological conditions. In adjusted models, male sex was associated with requiring a blood transfusion (OR 11.31, p=0.013); whilst having a pre-operative G&S sample had no impact on any patient outcome.
 
 
 
 Blood loss requiring blood transfusion in laparoscopic surgery is very low. Male sex and haematological conditions may present as independent risk factors for blood loss in laparoscopic cholecystectomy. Pre-operative G&S sampling has no impact on patient outcome and could safely be omitted in both elective and emergency cases unless a personalised assessment suggests otherwise.
