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Concomitant cholecystectomy and open heart surgery
Nicholas Charokopos1, Polychronis Antonitsis, Constantine Spanos
1Department of Thoracic and Cardiovascular Surgery, AHEPA University Hospital, Aristotelian University of Thessaloniki, Thessaloniki, Greece.
Insights
Synchronous cholecystectomy and open heart surgery are safe and effective in selected patients with concomitant cardiac disease and gallstones. This combined approach showed zero mortality and no immediate complications in a retrospective study.
Area of Science:
- Cardiovascular Surgery
- Gastrointestinal Surgery
Background:
- Gallstones (cholelithiasis) frequently coexist with cardiac disease.
- Simultaneous surgical intervention for both conditions requires careful evaluation.
Purpose of the Study:
- To assess the safety and efficacy of performing cholecystectomy concurrently with open heart surgery.
- To compare outcomes of synchronous procedures versus open heart surgery alone.
Main Methods:
- Retrospective study of 1257 patients (1999-2004).
- Group A: 9 patients underwent synchronous cholecystectomy and open heart surgery.
- Group B: 1248 patients underwent open heart surgery alone. Cholecystectomy was performed via open (77.7%) or laparoscopic (22.2%) approach.
Main Results:
- Synchronous procedures involved a mean of 2.5 bypass grafts and 348.4 min operative time.
- Patients undergoing combined surgery had longer intubation (25.7 h) and hospital stays (19.2 days) compared to controls.
- No intra-abdominal complications or mediastinitis were observed; mortality rate was zero in the combined group.
Conclusions:
- Synchronous cholecystectomy and open heart surgery can be safely performed in carefully selected patients.
- This combined approach offers a viable option for patients with both cardiac and gallbladder disease.
Purpose:
Cholelithiasis may be present concomitantly with cardiac disease. We performed a retrospective study to verify the safety and efficacy of synchronous cholecystectomy and open heart surgery.
Methods:
Between 1999 and 2004, we performed synchronous cholecystectomy and open heart surgery in nine patients (group A) and open heart surgery alone in 1248 patients (group B). Open heart surgery was performed with open cholecystectomy (OC) in seven (77.7%) patients and with laparoscopic cholecystectomy (LC) in two (22.2%) patients. One patient with unstable angina and acute cholecystitis underwent simultaneous procedures. The indications for open heart surgery were coronary artery disease in eight (88.8%) patients and severe aortic stenosis in one (11.2%) patient.
Results:
In group A, the mean number of bypass grafts performed was 2.5 +/- 0.5, the mean operative time was 348.4 min, and patients remained intubated for 25.7 +/- 6.7 h. The mean intensive care unit (ICU) stay was 4.1 +/- 1.6 days and the mean postoperative hospital stay was 19.2 +/- 5.7 days. There was a significant difference between the two groups in these two variables. No intra-abdominal complications or mediastinitis occurred in the immediate postoperative period in the setting of concomitant procedures and the mortality rate was zero.
Conclusion:
Synchronous cholecystectomy and open heart surgery can be performed safely in selected patients.
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