Background: Acute cholecystitis (AC) is a severe complication after cardiovascular surgery (CS). The purpose of this study was to delineate the clinical picture of AC after CS to propose an optimal treatment strategy.
Methods: We retrospectively reviewed the records of 88 patients who underwent cholecystectomy for grade II or III AC between 2008 and 2019 (AC after CS: Group CS, n = 37; AC without CS: Group non-CS, n = 51).
Results: The proportion of grade III AC in Group CS was significantly higher than that in Group non-CS (73% vs 41%, P = .005). Furthermore, the incidences of acalculous (81% vs 39%) and gangrenous (86% vs 59%) AC were significantly higher in Group CS (P < .05 for both). In Group CS, 11 patients had had percutaneous drainage preceding surgery, for whom cholecystectomy within 3 days was eventually necessary because their general condition was exacerbated. The incidence of a positive culture from the gallbladder bile and blood samples of Group CS were significantly higher (P < .05 for both); multidrug-resistant bacteria were detected at an especially high rate. However, the morbidity rate was comparable, and zero mortality was achieved in both groups.
Conclusions: Timely surgical intervention without hesitation is recommended for AC after CS.
Keywords: acalculous cholecystitis; acute cholecystitis; cardiovascular surgery; gangrenous cholecystitis; severity of acute cholecystitis.
© 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery.