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Surgical Endoscopy

Published in:

01-07-2007

A nontransfusional perioperative management regimen for patients with sickle cell disease undergoing laparoscopic cholecystectomy

Authors: D. R. Leff, T. Kaura, T. Agarwal, S. C. Davies, J. Howard, A. C. Chang

Published in: Surgical Endoscopy | Issue 7/2007

Abstract

Background

Patients with sickle cell disease (SCD) are at increased risk for cholelithiasis. Laparoscopic cholecystectomy is the most frequent general surgical operation performed for this group of patients. Acute chest syndrome (ACS) is the most common cause of postoperative death among SCD patients. This study aimed to evaluate the impact of a novel perioperative management regimen involving prophylactic continuous positive airways pressure (CPAP) ventilation and avoidance of preoperative blood transfusion on postoperative SCD-related complications after laparoscopic cholecystectomy.

Methods

A retrospective study included all SCD patients who underwent laparoscopic cholecystectomy since 1997 at our institution. Medical notes were analyzed to assess the rates of postoperative complications in relation to the severity of SCD.

Results

A total of 13 patients were identified. There were no recorded episodes of acute painful crises and only one patient experienced an episode of ACS requiring protracted CPAP.

Conclusion

Laparoscopic cholecystectomy can be safely performed for SCD patients without prior blood transfusion. A defined perioperative regimen including the use of routine postoperative prophylactic CPAP for these patients helps to reduce SCD-related postoperative complications such as ACS and painful vaso-occlusive crises.

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Title: A nontransfusional perioperative management regimen for patients with sickle cell disease undergoing laparoscopic cholecystectomy
Authors: D. R. Leff
T. Kaura
T. Agarwal
S. C. Davies
J. Howard
A. C. Chang
Publication date: 01-07-2007
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 7/2007
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-006-9054-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A nontransfusional perioperative management regimen for patients with sickle cell disease undergoing laparoscopic cholecystectomy

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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