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

Future Oncol. 2017 Apr;13(9):799-807. doi: 10.2217/fon-2016-0536. Epub 2017 Feb 24.

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.

Keywords: blood transfusion; clinical audit; morbidity; mortality; surgery.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Transfusion* / methods
  • Disease Management
  • Female
  • Humans
  • Intraoperative Care*
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy* / adverse effects
  • Pancreaticoduodenectomy* / methods
  • Postoperative Complications / diagnosis
  • Preoperative Care*
  • Retrospective Studies
  • Risk Factors
  • Transfusion Reaction
  • Young Adult