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Concomitant cholecystectomy and coronary artery bypass
Hitoshi Hirose1, Atsushi Amano, Akihito Takahashi
1Department of Cardiovascular Surgery, Kobari General Hospital, Chiba, Japan.
Insights
Simultaneous gallbladder removal and coronary artery bypass grafting (CABG) is safe. This combined surgery for patients with gallstones and heart disease did not increase complications, proving it a feasible option.
Area of Science:
- Cardiovascular Surgery
- Gastrointestinal Surgery
- Surgical Outcomes
Background:
- Gallstones (cholelithiasis) frequently coexist with coronary artery disease.
- Combined surgical procedures require careful evaluation for patient safety.
Purpose of the Study:
- To assess the safety and feasibility of performing cholecystectomy concurrently with coronary artery bypass grafting (CABG).
Main Methods:
- A retrospective study analyzed 55 patients who underwent combined cholecystectomy and CABG.
- Exclusion criteria included choledocholithiasis and acute cholecystitis.
- Cholecystectomy utilized an extended upper abdominal incision from the midsternal one.
Main Results:
- The study included 55 patients (mean age 64.6 years), with 87.3% receiving gastroepiploic artery grafts.
- Average operative time was 376 minutes, with a mean ICU stay of 3.9 days.
- No intra-abdominal complications, feeding delays, or bowel obstructions were reported.
Conclusions:
- Combined cholecystectomy and CABG is a safe and feasible procedure.
- This approach does not elevate postoperative complication rates in selected patients.
Introduction And Methods:
Cholelithiasis is a common disorder which may be present with coronary artery disease. Concomitant cholecystectomy and coronary artery bypass grafting (CABG) was performed in selected patients and retrospective study was performed to verify the safety of the concomitant surgery.
Results:
A total of 55 patients (41 males and 14 females, mean age 64.6 8.7 years) underwent concomitant cholecystectomy and CABG between 1992 and 2001 at the Shin-Tokyo Hospital Group. Exclusion from concomitant surgery was choledocholithiasis and/or acute cholecystitis. Cholecystectomy was performed via an upper abdominal incision extending the mid-sternal incision. In 48 patients (87.3%), the gastroepiploic artery (GEA) was used for coronary revascularization. The mean number of bypass grafts was 3.6 1.2. The mean operative time, intubation period, ICU stay, and postoperative hospital stay were 376 minutes, 15.6 hours, 3.9 days, and 23.0 days, respectively. Postoperative feeding was resumed 1 day after extubation. No intra-abdominal complications, delays in feeding, abdominal wound complications or postoperative bowel obstruction were observed.
Conclusions:
Concomitant surgery of cholecystectomy and CABG did not increase the postoperative complications, and it is a feasible procedure of choice.
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