Description
Adina Maria MARINCIU, Florin Dan UNGUREANU, Dan Ioan ULMEANU, Theodor CEBOTARU
BACKGROUND: Acute cholecystitis is a possible gastrointestinal complication after cardiac surgery with rare frequency, difficult diagnosis, but lead to high morbidity and mortality. AIM: We aimed to identify the best therapeutic approach for this complication.
METHODS: We analysed 44 cases of cholecystitis through 2240 patients who underwent cardiac surgery at Monza Hospital Bucharest, during 2013-2018. Data collection included preoperative variables, cardiac surgical procedure, postoperative predictors and outcomes.
RESULTS: sex ratio M/F:2,38 and median age was 62 years old. Acalculous cholecystitis was more prevalent than calculous cholecystitis. 37 patients were treated medically and 7 patients underwent surgery. Laparoscopic cholecystectomy was performed on 4 patients, one case required conversion, and other 3 cases open cholecystectomy. Cardiac procedures performed were: 35 combined and complex cases (multiple CABG, multiple valve), only 9 single valve replacement/repair.
CONCLUSIONS: 2% patients who underwent complex cardiac surgery developed postoperative cholecystitis. Prompt detection, early diagnostic and conservative treatment initiation are necessary, but in case of perforation or clinical unfavorable status, urgent surgical intervention is required. Although the gold standard is laparoscopic cholecystectomy, for cardiac patients open cholecystectomy could be a correct option. The key remains a multidisciplinary approach.
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