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Treatment of acute cholecystitis after cardiovascular surgery

Kimihiko Ueno1, Tetsuo Ajiki1, Daisuke Tsugawa1

  • 1Department of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Journal of Hepato-Biliary-Pancreatic Sciences
|September 19, 2019
PubMed

Insights

Acute cholecystitis after cardiovascular surgery often leads to gangrenous inflammation. Early surgical intervention is recommended, even for less severe cases, to improve outcomes for these complex patients.

Area of Science:

  • Cardiovascular Surgery
  • Gastrointestinal Surgery
  • Postoperative Complications

Background:

  • Acute cholecystitis (AC) following cardiovascular surgery (CS) is rare but associated with severe outcomes.
  • Limited clinical data exists on AC after CS, necessitating further investigation.

Purpose of the Study:

  • To investigate the clinical features of acute cholecystitis (AC) in patients who have undergone cardiovascular surgery (CS).
  • To evaluate the severity, timing, surgical outcomes, and pathological findings of AC after CS.

Main Methods:

  • Retrospective analysis of 26 patients who underwent surgery for AC after CS between 2001 and 2018.
  • Evaluation of AC severity, onset, surgical outcomes, and pathological findings, compared to a control group.

Main Results:

  • 46% of AC after CS cases were Grade III severity.
  • AC after CS showed a higher rate of gangrenous cholecystitis (88%) and extended hospital stays compared to controls.
  • The mortality rate for AC after CS was 12%.

Conclusions:

  • Over 80% of AC after CS cases presented with gangrenous cholecystitis.
  • Early surgical intervention for AC after CS, even Grade III, may be necessary due to the high rate of gangrenous changes.
Abstract

Keywords:
Acute cholecystitisCardiovascular surgeryEarly cholecystectomyGangrenous cholecystectomySeverity of AC

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