SP7.10 Routine Preoperative Blood Group and Save Testing Is Unnecessary for Elective and Emergency Cholecystectomy: A retrospective multicentre study

Abstract Aim Laparoscopic cholecystectomy is one of the most commonly performed procedure by general surgeons. Routine use of Group and Save (G&S) is widely practiced despite limited supporting evidence. This study aimed to evaluate the necessity of routine G&S by assessing perioperative blood transfusion rates. Methods This was a multicentre retrospective observational study of all consecutive adult patients undergoing elective and emergency cholecystectomy at three hospitals between August 2023 and July 2024. Data collected included patient demographics, operative details, Group and Save (G&S), cross-matching, and perioperative blood transfusion requirements. The laboratory cost of analysing a G&S sample is estimated to be £36 per patient and £124 for each unit for cross match. Results 564 patients were identified, median age was 53 years and 404 (71.6%) were female. 212 (37.6%) also had intra-operative cholangiogram and 72 (12.8%) had common bile duct exploration. 561 (99.5%) patients had pre-operative G&S. 31 (5.5%) also had cross match, with a total of 54 units cross matched. Two (0.4%) patients required blood transfusion within 30 days of surgery, both after 7 days of surgery. The cost estimated to be £20,304 for G&S and £6,696 for cross match - a total cost of £27,000. Conclusions Perioperative blood transfusion is exceedingly rare in patients undergoing cholecystectomy. Routine G&S testing imposes significant costs and can lead to unnecessary delays if not performed promptly. Our findings suggest that a routine G&S policy is unnecessary, and we recommend adopting a 'highly selective' G&S approach.