Abboud, MR

Black, D.

Earles, AN

Haberkern, CM

Idowu, O

Koshy, M

Neumayr, LD

Orringer, EP

Robertson, SM

Vichinsky, EP

Cholecystectomy is the most common surgical procedure performed in sickle cell anemia (SCA) patients. We investigated the effects of transfusion and surgical method on perioperative outcome. A total of 364 patients underwent cholecystectomy: group 1 (randomized to aggressive transfusion) 110 patients; group 2 (randomized to conservative transfusion) 120 patients; group 3 (nonrandomized nontransfusion) 37 patients; and group 4 (nonrandomized transfusion) 97 patients. Patients were similar except group 3 patients were more likely to be female, over 20 years old, smokers, and more healthy by American Society of Anesthesiologists (ASA) physical status score. Total complication rate was 39%: sickle cell events 19%; intraoperative or recovery room events 11%; transfusion complications 10%; postoperative surgical events 4%; and death 1%. Group 3 patients had the highest incidence of sickle cell events (32%). Open cholecystectomies were performed in 58% and laparoscopic in 42%. Laparoscopic patients were younger and more healthy by ASA score. Laparoscopic patients had longer anesthesia time (3,2 v 2.9 hours), but shorter hospitalization time (6.4 days v 9.8). Complications were similar between these two groups, We conclude that SCA patients undergoing cholecystectomy have a high perioperative morbidity, and the incidence of sickle cell events may be higher in patients not preoperatively transfused. We recommend a conservative preoperative transfusion regimen, and we encourage the use of the laparoscopic technique for SCA patients undergoing elective cholecystectomy. (C) 1997 by The American Society of Hematology.</p

Proceedings - University of Groningen

Cholecystectomy in sickle cell anemia patients:Perioperative outcome of 364 cases from the national preoperative transfusion study

Cholecystectomy in sickle cell anemia patients:Perioperative outcome of 364 cases from the national preoperative transfusion study

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Proceedings - University of Groningen