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Multidisciplinary strategies in bloodless medicine and surgery for patients undergoing pancreatectomy
Journal article   Peer reviewed

Multidisciplinary strategies in bloodless medicine and surgery for patients undergoing pancreatectomy

Marian Khalili, William F. Morano, Luiz Marconcini, Mohammad F. Shaikh, Elizabeth M. Gleeson, Michael Styler, Marcus Zebrower and Wilbur B. Bowne
The Journal of surgical research, v 229, pp 208-215
Sep 2018
DOI: https://doi.org/10.1016/j.jss.2018.04.009
PMID: 29936992
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Bloodless Surgery and Medicine Jehovah’s Witness Pancreatic Surgery Pancreaticoduodenectomy
Bloodless pancreatic surgery (BPS) is rarely performed and/or reported. We aim to characterize perioperative and anesthetic strategies in BPS. A literature search was performed on MEDLINE looking for case reports/case series using search terms (“Jehovah's Witness” [All Fields]) AND (“Pancreatic Surgery” [All Fields] OR “Pancreaticoduodenectomy” [All Fields] OR “Distal Pancreatectomy” [All Fields]). Data regarding categorical variables are reported as proportions and quantitative continuous variables as medians with ranges or means with standard deviation. Forty-one patients requiring BPS are reported in the literature with three additional cases from our institution (n = 44). The data analyzed included clinicopathologic factors, BPS strategies, patient complications, and in-hospital mortality. The most common procedure and diagnosis were pancreaticoduodenectomy (n = 34, 77.3%) and pancreatic ductal adenocarcinoma (n = 12, 27.3%), respectively. Transfusion reduction strategies in BPS fell into three categories: preoperative, intraoperative, and postoperative. Preoperative strategies included iron supplementation (n = 24, 54.5%) and erythropoietin administration (n = 14, 41.2%). Intraoperative strategies included acute normovolemic hemodilution (n = 30, 68%) and cell saver (n = 4, 9.1%). Postoperative strategies included erythropoietin (n = 16, 48.5%) and iron supplementation (n = 16, 48.5%). Complications occurred in 21 (60%) patients. There was no in-hospital mortality among the 44 patients in this cohort. A broad spectrum of bloodless medicine and surgery practices were used based on patient selection, multidisciplinary practice, and preference. With careful perioperative and anesthetic management, BPS can be performed with good outcomes.

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4 citations in Web of Science
5 citations in Scopus

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#3 Good Health and Well-Being

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Web of Science research areas
Surgery
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