Cholecystectomy in the potential heart transplant patient

G. B. Boline, R. R.M. Gifford, H. C. Yang, Kane High, F. A. Hensley, J. E. Burg, C. B. Wisman

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19 Citations (Scopus)

Abstract

The management of cholelithiasis with gallstone pancreatitis in the heart transplant candidate is a difficult problem. Biliary tract surgery in the heart transplant candidate presents an additional set of clinical risks in view of extensive heart disease. We report the cases of three patients with symptomatic cholelithiasis with gallstone pancreatitis who were successfully operated on while awaiting cardiac allografts. Each patient was preoperatively prepared with (1) a lumbar epidural catheter for postoperative pain control with epidural opioids, (2) a balloon-tipped (Swan-Ganz) catheter and arterial line for perioperative monitoring, and (3) an intraaortic balloon pump for circulatory support with full heparinization after epidural catheter placement. In addition, preoperative optimization of cardiovascular function with pharmacologic agents was carefully achieved for 6 to 12 hours before surgery. All three patients had stable intraoperative courses, with less than a 300 ml blood loss. Their postoperative outcomes were without surgical complication. We think that biliary tract surgery may be safely accomplished in the heart transplant candidate with careful, appropriate preparation and meticulous surgical technique. We also present our management algorithm for heart transplant patients with cholelithiasis before and after operation.

Original languageEnglish (US)
Pages (from-to)269-274
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume10
Issue number2
StatePublished - Jan 1 1991

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Cholecystectomy
Cholelithiasis
Transplants
Catheters
Biliary Tract
Gallstones
Pancreatitis
Vascular Access Devices
Postoperative Pain
Opioid Analgesics
Thoracic Surgery
Allografts
Heart Diseases

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

Cite this

Boline, G. B., Gifford, R. R. M., Yang, H. C., High, K., Hensley, F. A., Burg, J. E., & Wisman, C. B. (1991). Cholecystectomy in the potential heart transplant patient. Journal of Heart and Lung Transplantation, 10(2), 269-274.
Boline, G. B. ; Gifford, R. R.M. ; Yang, H. C. ; High, Kane ; Hensley, F. A. ; Burg, J. E. ; Wisman, C. B. / Cholecystectomy in the potential heart transplant patient. In: Journal of Heart and Lung Transplantation. 1991 ; Vol. 10, No. 2. pp. 269-274.
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Boline, GB, Gifford, RRM, Yang, HC, High, K, Hensley, FA, Burg, JE & Wisman, CB 1991, 'Cholecystectomy in the potential heart transplant patient', Journal of Heart and Lung Transplantation, vol. 10, no. 2, pp. 269-274.

Cholecystectomy in the potential heart transplant patient. / Boline, G. B.; Gifford, R. R.M.; Yang, H. C.; High, Kane; Hensley, F. A.; Burg, J. E.; Wisman, C. B.

In: Journal of Heart and Lung Transplantation, Vol. 10, No. 2, 01.01.1991, p. 269-274.

Research output: Contribution to journalArticle

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Boline GB, Gifford RRM, Yang HC, High K, Hensley FA, Burg JE et al. Cholecystectomy in the potential heart transplant patient. Journal of Heart and Lung Transplantation. 1991 Jan 1;10(2):269-274.