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[Cholelithiasis in heart transplant patients].
F Menegaux1, C Huraux, P Jordi-Galais
1Service de chirurgie générale et digestive, hôpital de la Pitié, 47-83 boulevard de l'Hôpital, 75651 Paris, France. fabrice.menegaux@psl.ap-hop-paris.fr
Annales De Chirurgie
|March 14, 2001
Summary
Heart transplant recipients have increased rates of gallstones. Laparoscopic cholecystectomy is safe and effective, even for asymptomatic gallstones, but open surgery may be better for acute cholecystitis in these patients.
Area of Science:
- Cardiology
- Transplant Surgery
- Gastroenterology
Context:
- Heart transplant recipients face an increased incidence of cholelithiasis (gallstones).
- Gallstones can lead to serious septic complications in immunosuppressed transplant patients.
Purpose:
- To report on 27 heart transplant recipients who underwent cholecystectomy for gallstones.
- To evaluate the indications and safety of cholecystectomy in this specific patient population.
Summary:
- A retrospective study reviewed 27 heart transplant recipients undergoing cholecystectomy between 1991-1999.
- Laparoscopic cholecystectomy showed low morbidity, with no deaths or conversions to laparotomy.
- Open cholecystectomy was used for urgent cases, with a wound abscess being the only complication.
Impact:
- Systematic ultrasound screening for gallstones post-heart transplant is recommended.
- Laparoscopic cholecystectomy is justified for asymptomatic gallstones due to low morbidity.
- Open cholecystectomy is preferred for acute cholecystitis to minimize severe biliary complications in immunosuppressed patients.