656 Is Routine Group and Save Required for Laparoscopic Cholecystectomy? An Audit of a High Volume NHS Centre

Abstract Aim Bleeding is a recognised complication of laparoscopic cholecystectomy (LC). Yet very few patients require blood transfusion in the perioperative phase. However, it is routine practice for patients undergoing LC to have a group and save (G&S) prior to surgery. This audit aims to assess number of LC patients at Northumbria Healthcare NHS Foundation Trust who required transfusions, and the number who had “valid” group and save (G&S) samples obtained within 72 hours pre-operatively. Method Records of patients who had either elective or emergency LC at Northumbria Healthcare NHS Trust between 1st January 2021 to 31st December 2022 were reviewed retrospectively using theatre and transfusion records. Results A total of 836 patients were included (557 female and 279 male, age ranges 19 to 90 years old). Out of 571 elective LC, none required transfusion. 383 had a “valid” G&S, despite 360 having at least one historical sample. Of 265 emergency LC, 245 patients had a “valid” G&S, despite 207 having at least one historical sample. No patients needed intra-operative transfusion. 2 emergency LC patients required non-urgent post-operative transfusion where G&S sampling could have been taken once transfusion decision was made. One patient had cirrhosis and anaemia secondary to liver metastases, and the other developed a post-operative liver haematoma. Conclusions This audit suggested that no patients required intra-operative transfusion, and very few patients required peri-operative transfusion for LC. Eradication of routine G&S sampling is likely to provide financial and environmental benefits without increasing the risk profile of this procedure.