[Gallstone complications in sickle cell patients]. / Complications lithiasiques chez les patients drépanocytaires.
Rev Med Interne
; 43(8): 479-486, 2022 Aug.
Article
en Fr
| MEDLINE
| ID: mdl-35688668
ABSTRACT
Chronic haemolysis exposes patients with sickle cell disease (SCD) to the development of black pigment gallstones, which can trigger biliary complications. In order to avoid these complications, elective cholecystectomy is recommended in France for all SCD patients with detected gallstones. However, all surgeries, and especially abdominal surgeries, entail an increased risk of vaso-occlusive complications in the peri- and post-operative periods, the most dreadful one being the acute chest syndrome. Preoperative transfusion has been shown in several studies to reduce acute postoperative complications, but exposes the patient to definitive alloimmunization, or even delayed post- transfusion haemolysis, justifying a recent trend towards transfusion sparing. The conditions for avoiding transfusion for a simple and frequent surgery such as cholecystectomy are based on a benefit- risk balance, and must be discussed on a case-by-case basis by the SCD specialist. In particular, it seems fully justified to perform prophylactic preoperative transfusion in patients with a history of recent vaso-occlusive crisis or acute chest syndrome (within 6 months preoperatively), and those operated on in an emergency setting, who are particularly at risk of postoperative events.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Cálculos Biliares
/
Síndrome Torácico Agudo
/
Reacción a la Transfusión
/
Anemia de Células Falciformes
Límite:
Humans
Idioma:
Fr
Revista:
Rev Med Interne
Año:
2022
Tipo del documento:
Article