A Retrospective Analysis of the Clinical Utility and Cost-Effectiveness of Routine Preoperative Blood Grouping and Saving Protocols in Patients Undergoing Laparoscopic Surgical Procedures

Introduction: In patients undergoing elective laparoscopic cholecystectomy or appendicectomy, standard preoperative practice often includes blood grouping and saving (G&S). Notwithstanding the infrequent requirement for blood transfusion during these procedures, the procurement and laboratory analysis of G&S specimens impose a cost of £31 (approximately $40) per sample. This investigation seeks to evaluate blood transfusion utilization in these surgical cohorts to ascertain the clinical justification for routine G&S sampling versus its potential as a dispensable expenditure. Methods: A retrospective review of patient records was performed for individuals who underwent laparoscopic cholecystectomy or laparoscopic appendicectomy between January 2023 and June 2024. The data extracted comprised the timing of (G&S) procedures, preoperative and postoperative haemoglobin concentrations, the timing of any blood transfusions administered, and the total number of blood units transfused. Results: A total of 310 patients participated in this investigation. Within the laparoscopic cholecystectomy cohort (n=164), 129 individuals (78.65%) underwent preoperative grouping and screening (G&S) for blood compatibility. In the laparoscopic appendicectomy group (n=146), 95 patients (65.06%) received preoperative G&S. It is noteworthy that no patient within the entire cohort of 310 required a blood transfusion within the 30-day postoperative period. Conclusions: The results indicate that routine Group and Save (G&S) blood sampling does not represent a clinically necessary expenditure for patients undergoing elective laparoscopic appendectomy or cholecystectomy. To optimize resource allocation and minimize non-essential costs, it is advised that G&S sampling be selectively employed in patient populations identified as being at elevated risk for perioperative complications requiring blood transfusion.