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Cholecystectomy in patients with hematologic malignancies.
Camille L Stewart1, Thuy B Tran1, Andrew Nguyen1
1Department of Surgery, City of Hope, Duarte, CA, USA.
American Journal of Surgery
|October 29, 2021
Summary
Cholecystectomy is safe for patients with hematologic malignancies. Intraoperative blood transfusion during gallbladder removal may increase inpatient postoperative stay, highlighting a key factor for improved patient outcomes.
Area of Science:
- Hepatobiliary surgery
- Hematology
- Oncology
Background:
- Gallbladder removal (cholecystectomy) in patients with blood cancers (hematologic malignancies) is not well understood.
- Many patients with hematologic malignancies have underlying conditions or treatments that may increase surgical risks.
Purpose of the Study:
- To evaluate the safety and outcomes of cholecystectomy in patients with hematologic malignancies.
- To identify factors associated with complications and length of stay after cholecystectomy in this patient population.
Main Methods:
- Retrospective review of 64 patients with hematologic malignancies who underwent cholecystectomy.
- Analysis of patient demographics, surgical procedures, complications, and postoperative outcomes.
- Assessment of diagnostic accuracy of ultrasound for acute cholecystitis.
Main Results:
- Cholecystectomy was performed for various gallbladder conditions including acute cholecystitis, gangrenous cholecystitis, chronic cholecystitis, and gallstones.
- A high percentage of patients had a history of hematopoietic cell transplantation and/or recent immunosuppressive medication use.
- Ultrasound showed a 39% false-negative rate for acute nongangrenous cholecystitis.
- Intraoperative transfusion was associated with a longer postoperative hospital stay (p=0.03).
Conclusions:
- Cholecystectomy can be performed safely in patients with hematologic malignancies.
- Intraoperative blood transfusion is a significant factor influencing postoperative length of stay for inpatients undergoing cholecystectomy.
