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[Coronary artery bypass grafting using the right gastroepiploic artery and cholecystectomy--two experiences of
1Department of Cardiovascular Surgery, Koseiren Hiroshima General Hospital, Japan.
Insights
Simultaneous cholecystectomy during coronary artery bypass grafting (CABG) using the right gastroepiploic artery (GEA) is beneficial. This combined procedure minimizes surgical risks and patient recovery time for cholelithiasis patients.
Area of Science:
- Cardiovascular Surgery
- Gastrointestinal Surgery
- Surgical Innovation
Background:
- Coronary artery bypass grafting (CABG) is a common procedure for heart disease.
- Cholelithiasis (gallstones) can be incidentally found before CABG.
- Right gastroepiploic artery (GEA) is a frequently used graft in CABG.
Observation:
- Two cases of cholelithiasis were identified pre-CABG in patients scheduled for GEA grafting.
- Simultaneous CABG and cholecystectomy were performed in these patients.
- Favorable outcomes were observed in both cases.
Findings:
- The combined procedure is highly effective and feasible.
- Utilizing GEA during CABG facilitates easy access for simultaneous cholecystectomy.
- This approach reduces overall surgical risks, including anesthetic complications and infection.
- Cholecystectomy during CABG resulted in minimal operative invasion, with no significant impact on operative time, diet initiation, or hospital stay.
Implications:
- Simultaneous cholecystectomy should be considered when cholelithiasis is detected before GEA-based CABG.
- This strategy offers a safe and efficient approach to managing concurrent conditions.
- It potentially improves patient outcomes and resource utilization in cardiac surgery settings.
Abstract:
For two cases of cholelithiasis found before the coronary artery bypass grafting (CABG) using the right gastroepiploic artery (GEA), CABG and cholecystectomy were performed simultaneously, and favorable results were obtained. This mode of operations is very useful, being able to make use of GEA easily upon laparotomy, in addition to reduce the risks of surgical complications such as anesthetic accident, infection, etc. Further, both two cases had nearly no operative invasion by cholecystectomy related to either operative time, ingestion starting time or duration of hospital stay. Therefore, whenever cholelithiasis is found before CABG using GEA in the future, cholecystectomy shall be performed simultaneously.