Maximum surgical blood order schedule for pancreatoduodenectomy: a long way from uniform applicability!

Author:

Barreto Savio G123,Singh Amanjeet1,Perwaiz Azhar1,Singh Tanveer1,Singh Manish Kumar4,Chaudhary Adarsh1

Affiliation:

1. Department of Gastrointestinal Surgery, Gastrointestinal Oncology, & Bariatric Surgery, Medanta Institute of Digestive & Hepatobiliary Sciences, Medanta, The Medicity, Gurgaon, India

2. Hepatobiliary & Oesophagogastric Unit, Division of Surgery & Perioperative Medicine, Flinders Medical Center, Bedford Park, Adelaide, South Australia, Australia

3. School of Medicine, Faculty of Medicine, Nursing & Health Sciences, Flinders University, Adelaide, South Australia, Australia

4. Department of Clinical Research, Medanta, The Medicity, Gurgaon, India

Abstract

Background: Unnecessary preoperative ordering of blood and blood products results in wastage of a valuable life-saving resource and poses a significant financial burden on healthcare systems. Aim: To determine patient-specific factors associated with intra-operative transfusions, and if intra-operative blood transfusions impact postoperative morbidity. Patients & methods: Analysis of consecutive patients undergoing pancreatoduodenectomy (PD) for pancreatic tumors. Results: A total of 384 patients underwent a classical PD with an estimated median blood loss of 200 cc and percentage transfused being 9.6%. Pre-existing hypertension, synchronous vascular resection, end-to-side pancreaticojejunostomy and nodal disease burden significantly associated with the need for intra-operative transfusions. Intra-operative blood transfusion not associated with postoperative morbidity. Conclusion: Optimization of MSBOS protocols for PD is required for more judicious use of blood products.

Publisher

Future Medicine Ltd

Subject

Cancer Research,Oncology,General Medicine

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