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. 2023 Apr 1;277(4):e849-e855.
doi: 10.1097/SLA.0000000000005536. Epub 2022 Jul 15.

Intraoperative Blood Loss Estimation in Hepato-pancreato-biliary Surgery- Relevant, Not Reported, Not Standardized: Results From a Systematic Review and a Worldwide Snapshot Survey

Giampaolo Perri  1 , Giovanni Marchegiani  1 , Federico Reich  1 , Luca Casetti  1 , Martina Fontana  1 , Alessandro Esposito  1 , Andrea Ruzzenente  2 , Roberto Salvia  1 , Claudio Bassi  1
Affiliations

Intraoperative Blood Loss Estimation in Hepato-pancreato-biliary Surgery- Relevant, Not Reported, Not Standardized: Results From a Systematic Review and a Worldwide Snapshot Survey

Giampaolo Perri et al. Ann Surg. .

Abstract

Objective: To provide an overview of the current practice of intraoperative blood loss (BL) estimation in hepato-pancreato-biliary (HPB) surgery.

Background: Intraoperative BL is a major quality marker in HPB surgery and a predictor of perioperative outcomes. However, the method for BL estimation is not standardized.

Methods: A systematic review was performed of original studies published between 2006 and 2021 reporting the intraoperative BL of patients undergoing pancreatic or hepatic resections. A web-based snapshot survey was distributed globally to all members of the International Hepato-Pancreato-Biliary Association (IHPBA).

Results: A total of 806 studies were included; 480 (60%) had BL as their primary outcome, and 105 (13%) had BL as their secondary outcome. However, 669 (83%) did not specify how BL estimation was performed, and 9 different methods were found among the remaining 136 (17%) studies.The survey was completed by 252 surgeons. Most of the responders (94%) declared that they systematically performed BL estimation and considered BL predictive of postoperative complications after pancreatic (73%) and liver (74%) resection. All methods previously identified in the literature were used by responders with different frequencies. A calculation based on suction fluid amounts, operative gauze weight, and irrigation was the most used method in the literature (7%) and among responders (51%). Most responders (83%) felt that BL estimation in HPB surgery needs improved standardization.

Conclusions: Standardization of intraoperative BL estimation is urgently needed in HPB surgery to ensure the consistency of reporting and reproducibility.

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Conflict of interest statement

The authors report no conflicts of interest.

References

    1. Pratt W, Callery MP, Vollmer CM. Optimal surgical performance attenuates physiologic risk in high-acuity operations. J Am Coll Surg. 2008;207:717–730.
    1. Ejaz A, Spolverato G, Kim Y, et al. Variation in triggers and use of perioperative blood transfusion in major gastrointestinal surgery. Br J Surg. 2014;101:1424–1433.
    1. Dixon E, Datta I, Sutherland FR, et al. Blood loss in surgical oncology: neglected quality indicator? J Surg Oncol. 2009;99:508–512.
    1. Jaramillo S, Montane-Muntane M, Capitan D, et al. Agreement of surgical blood loss estimation methods. Transfusion. 2019;59:508–515.
    1. Lopez-Picado A, Albinarrate A, Barrachina B. Determination of perioperative blood loss: accuracy or approximation? Anesth Analg. 2017;125:280–286.

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