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[Simultaneous cholecystectomy and CABG for acute cholecystitis and post-infarction angina]
Y Sakakibara1, T Jikuya, S Adachi
1Department of Surgery, University of Tsukuba, Ibaraki, Japan.
Insights
This study presents a case of combined coronary artery bypass grafting (CABG) and cholecystectomy in a patient with severe coronary artery disease and acute cholecystitis. The successful combined procedure highlights its benefit for patients with unstable angina and gallbladder inflammation.
Area of Science:
- Cardiovascular Surgery
- Gastrointestinal Surgery
- Emergency Medicine
Background:
- A 71-year-old male presented with massive gastrointestinal bleeding and acute myocardial infarction.
- Coronary angiography revealed severe three-vessel coronary artery disease with reduced left ventricular ejection fraction (40%).
- The patient also had concurrent acute cholecystitis requiring surgical intervention.
Observation:
- A combined surgical approach was undertaken, involving coronary artery bypass grafting (CABG) and cholecystectomy.
- The procedures were performed via separate surgical approaches: median sternotomy for CABG and right upper transrectal laparotomy for cholecystectomy.
- The gastroepiploic artery was intentionally not used as a bypass graft.
Findings:
- The patient experienced an uneventful postoperative recovery following the combined surgical procedure.
- This case demonstrates the feasibility and safety of simultaneous CABG and cholecystectomy.
- Successful management of both critical conditions was achieved in a single operative setting.
Implications:
- Combined CABG and cholecystectomy can be a beneficial therapeutic strategy for patients presenting with acute cholecystitis and unstable angina.
- This approach may reduce overall treatment time and improve patient outcomes in complex clinical scenarios.
- Further investigation into the efficacy and safety of combined surgical interventions in similar patient populations is warranted.
Abstract:
A 71-year-old man was admitted to our hospital with massive GI bleeding and followed by acute myocardial infarction. Severe three vessel coronary artery disease with poor left ventricular performance (EF: 40%) was demonstrated by coronary angiography. He was referred for CABG. He had also cholecystitis, which needed surgical treatment simultaneously. Combined CABG and cholecystectomy were performed without using gastroepiploic artery as a bypass graft, and through separate median sternotomy and through right upper transrectal laparotomy. Postoperative course was uneventful. This combined procedure is beneficial for the patients with acute cholecystitis and unstable angina.