LAPAROSCOPIC CHOLECYSTECTOMY IN SICKLE CELL PATIENTS: A NONTRANSFUSIONAL PERIOPERATIVE MANAGEMENT.

Abstract

Background: The objective of this study is to evaluate the outcome of novel perioperative management involving prophylactic antibiotic, Intra Venous fluids and Intermittent Nasal Oxygen and avoidance of preoperative blood transfusion for Laparoscopic Cholecystectomy.

Methods: A prospective study included all sickle cell disease (SCD) and trait patients who underwent Laparoscopic Cholecystectomy from January 2007 to August 2010 at Acharya Vinoba Bhave Rural Hospital, attached to Datta Meghe Institute of Medical sciences university, Sawangi, Wardha. India

Result: A total of 26 patients underwent Laparoscopic Cholecystectomy. There were two recorded episodes of acute painful crises and three patients had postoperative fever. There were no recorded episodes of Acute Chest syndrome.

Conclusion: Laparoscopic Cholecystectomy can be safely performed for sickle cell anemia (disease and trait) patients, without preoperative blood transfusion. A defined perioperative regimen including use of antibiotic, IV fluids and Intermittent Nasal Oxygenation for these patients helps to reduce SCD related complications.

Keywords: Laparoscopy, Cholecystectomy, Sickle Cell, Nontransfusion, Haemoglobinopathy.