Feasibility and Safety of Concomitant Laparoscopic Cholecystectomy With Open-Heart Surgery: A Systematic Review and Our Early Clinical Experience

Abstract

Significant valvular or coronary artery disease may co-exist in patients presenting with symptomatic cholelithiasis. Isolated laparoscopic cholecystectomy in these cases is often associated with cardiac complications. Addressing the cardiac condition first may result in flaring up of cholecystitis during postoperative recovery and is associated with adverse outcomes. Open-heart surgery followed by laparoscopic cholecystectomy during a single operative setting is an option in these situations. The aim of our study is to review the published articles for this strategy and to share our initial experience with two such patients. PubMed, OVID Medline, and Cochrane library database were used, and we searched these databases using Medical Subject Headings (MeSH) terms and keywords from the inception date until August 1, 2023, and did not restrict our search to any language, study type, sample size, or publication date. All the publications reporting concomitant laparoscopic cholecystectomy and open-heart surgery were identified and a systematic review was carried out. Our first case underwent coronary artery bypass grafting and laparoscopic cholecystectomy. The second patient underwent a double valve replacement and laparoscopic cholecystectomy. Both the patients made an uneventful recovery, and are alive and doing well. Concomitant open-heart surgery and laparoscopic cholecystectomy in certain situations may be necessary and can be performed safely.

Keywords: cabg and cholecystectomy; cholecystectomy and cardiac surgery; cholecystitis and cardiac disease; concomitant laparoscopic surgery; coronary artery bypass grafting (cabg); gallstone and valvular dysfunction; laparoscopic cholecystectomy (lc); open heart surgery (ohs); systematic review; valve repair and cholecystectomy.

Figure 1. Flow Diagram for Search Strategy Using PRISMA Guidelines

LC: laparoscopic cholecystectomy; OHS: open-heart surgery; PRISMA: preferred reporting items for systematic review and meta-analysis. The flow diagram was drawn by the authors of this article.