Hamid Mohammed, Kershaw Marie, Bhakthavalsalan Resya, Shivamurthy Rishika, Davies Sian, Singhal Rishi, Nijjar Rajwinder, Wiggins Tom, Camprodon Ricardo, Ahmed Zuhair
University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham B15 2TH, UK.
Dudley Group NHS Foundation Trust, Russell's Hall Hospital, Pensnett Rd., Dudley DY1 2HQ, UK.
J Clin Med. 2024 May 7;13(10):2749. doi: 10.3390/jcm13102749.
: Laparoscopic cholecystectomy is associated with a high safety profile. This study seeks to quantify the incidence of blood transfusion in both the elective and emergency settings, examine related patient outcomes, and investigate selection criteria for pre-operative Group and Save (G&S) sampling. A prospective multi-centre observational study was conducted to investigate patients undergoing either elective or emergency laparoscopic cholecystectomy in the UK between January 2020 and May 2021. Multivariate logistical regression models were used to identify patient factors associated with the risk of transfusion and explore outcomes linked to pre-operative G&S sampling. This study comprised 959 patients, with 631 (65.8%) undergoing elective cholecystectomy and 328 (34.2%) undergoing emergency surgery. The median age was 48 years (range: 35-59), with 724 (75.5%) of the patients being female. Only five patients (0.5%) required blood transfusions, receiving an average of three units, with the first unit administered approximately six hours post-operatively. Among these cases, three patients (60%) had underlying haematological conditions. In adjusted models, male gender was significantly associated with the need for a blood transfusion (OR 11.31, = 0.013), while the presence of a pre-operative Group and Save sample did not demonstrate any positive impact on patient outcomes. The incidence of blood transfusion following laparoscopic cholecystectomy is very low. Male gender and haematological conditions may present as independent risk factors. Pre-operative G&S sampling did not yield any positive impact on patient outcomes and could be safely excluded in both elective and emergency cases, although certain population subsets will warrant further consideration.
腹腔镜胆囊切除术具有较高的安全性。本研究旨在量化择期和急诊情况下输血的发生率，检查相关的患者预后情况，并调查术前血型及抗体筛查（G&S）采样的选择标准。进行了一项前瞻性多中心观察性研究，以调查2020年1月至2021年5月期间在英国接受择期或急诊腹腔镜胆囊切除术的患者。使用多变量逻辑回归模型来确定与输血风险相关的患者因素，并探索与术前G&S采样相关的预后情况。本研究共纳入959例患者，其中631例（65.8%）接受择期胆囊切除术，328例（34.2%）接受急诊手术。中位年龄为48岁（范围：35 - 59岁），724例（75.5%）患者为女性。只有5例患者（0.5%）需要输血，平均接受3个单位的血液，首个单位在术后约6小时输注。在这些病例中，3例患者（60%）有潜在血液系统疾病。在调整模型中，男性性别与输血需求显著相关（比值比11.31，P = 0.013），而术前进行血型及抗体筛查样本对患者预后未显示出任何积极影响。腹腔镜胆囊切除术后输血的发生率非常低。男性性别和血液系统疾病可能是独立的危险因素。术前G&S采样对患者预后没有产生任何积极影响，可以在择期和急诊病例中安全地排除，尽管某些人群子集值得进一步考虑。
