COMPARISON OF HEMOSTASIS BY INTRAVENOUS TRANSAMIN ADMINISTRATION ALONE VERSUS TRANSAMIN-SOAKED PACKING IN THE GALLBLADDER BED ALONG WITH INTRAVENOUS TRANSAMIN IN CHOLECYSTECTOMY

Abstract

Objective: To compare the hemostatic efficacy of intravenous transamin alone versus combined intravenous and transamin-soaked re-packing in the gallbladder bed during cholecystectomy.

Study Design: Quasi-experimental study

Place and Duration: Department of General, Thoracic and Paediatric Surgery, and Department of Anesthesiology at a Tertiary Care Hospital in Kharian, Kharian, Pakistan.

Methodology: This quasi-experimental study was carried out on 110 patients undergoing elective laparoscopic cholecystectomy. The patients were randomly divided into two equal groups in the study. Group A received intravenous transamine (10 mg/kg) only, Group B received intravenous transamin and topical transamin soaked packing (500 mg poured over the gauze) applied for three minutes to the gallbladder bed. Intraoperative blood loss, output of postoperative drainage, surgery time, hospital stay, and postoperative complications were recorded.

Results: The two groups were also similar with respect to age and gender. There was a significant difference in mean intraoperative blood loss between group B (34.83 ± 7.7 mL) and A (49.47 ± 11.55 mL; p < 0.05). Also, surgical drain output was significantly less in group B (47.98 ± 12.56 mL) than for group A (72.69 ± 14.14 mL; P < 0.05).

Conclusion: Combined intravenous and topical TXA significantly improved hemostasis, decreased blood loss and reduced hospital stay compared to intravenous TXA alone during cholecystectomy.