Abstract:
BACKGROUND:Cardiovascular disease (CVD) and gallstones are reported to be strongly associated because both diseases are frequently part of a metabolic syndrome. Laparoscopic cholecystectomy (LC) has become the standard treatment for gallbladder disease around the world. Cardiovascular disease is considered as an absolute or relative contraindication for LC; however, clinical information regarding the applicability of LC for treating gallbladder disease in CVD patients is lacking. This study aims to assess the suitability of LC for the treatment of gallbladder disease in CVD patients. METHODS:The medical records of 66 patients with severe CVD (including valvular heart disease, ischemic heart disease, and heart failure) and gallbladder disease (CVD-group) who underwent LC between 1966 and 2005 were retrospectively reviewed. Furthermore, these data were compared with the clinical features and outcomes of 8,834 patients with gallbladder disease who underwent LC but did not have severe CVD (NCVD-group). RESULTS:Of the 8,900 patients with gallbladder disease undergoing LC, the 66 (0.74%) who comprised the CVD-group clearly exhibited advanced age, male predominance, higher blood urea nitrogen (BUN) levels, and a longer duration of hospitalization as compared with the NCVD-group patients. A longer duration of hospitalization and a higher incidence of acute cholecystitis and chronic cholecystitis were identified as independent factors differentiating the CVD-group patients, who had previously undergone open-heart surgery, from the NCVD-group patients who underwent LC. For the CVD-group patients, adjustment of anticoagulant therapy contributed to the longer duration of hospitalization, but postoperative complications did not. Advanced age and male predominance were identified as independent factors differentiating the patients who developed ischemic heart disease that required intervention from the NCVD-group patients undergoing LC. The operative morbidity and mortality rates of LC are likely to be similar when it is used to treat selected patients with severe CVD and gallbladder disease and when it is used to treat patients with gallbladder disease and no CVD. CONCLUSIONS:Laparoscopic cholecystectomy is a suitable procedure for treating selected patients with severe CVD and gallbladder disease, and its operative morbidity and mortality rates are similar in these patients and in patients with gallbladder disease alone. Nevertheless, appropriate preoperative preparations and established operative techniques in the hands of an experienced surgeon are mandatory.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Liu YY,Yeh CN,Lee HL,Chu PH,Jan YY,Chen MFdoi
10.1007/s00268-009-0072-9subject
Has Abstractpub_date
2009-08-01 00:00:00pages
1720-6issue
8eissn
0364-2313issn
1432-2323journal_volume
33pub_type
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-006-0837-3
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Postoperative outcome prediction in elderly is based on preoperative physical status but its predictive value is uncertain. The goal was to evaluate the value of risk assessment performed perioperatively in predicting outcome in case of admission to an intensive care unit (ICU). METHODS:A total of 108 posts...
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更新日期:1998-10-01 00:00:00
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abstract:BACKGROUND:The role of lymphadenectomy in adrenocortical carcinoma resection is controversial. Therefore, we conducted a population-based study to assess the association between positive lymph nodes (LN) and survival. METHODS:The Surveillance, Epidemiology, and End Results set of cancer registries were utilized. The a...
journal_title:World journal of surgery
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abstract::The authors' affiliations are updated as reflected here. ...
journal_title:World journal of surgery
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00268-020-05519-w
更新日期:2020-08-01 00:00:00
abstract::Subfascial elimination of incompetent perforating veins is the most effective therapeutic principle in the treatment of trophic skin disorders associated with varicosis. A recently developed endoscopic technique allows accurate sectioning of perforating veins with direct observation of the veins and minor trauma. From...
journal_title:World journal of surgery
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更新日期:1992-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2015-02-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9800-9
更新日期:2009-01-01 00:00:00
abstract::In the Surgical Department of the University of Erlangen, 307 reconstructions in all areas of the arterial tree were performed with PTFE (GORE-TEX) grafts, of which 188 were performed in the femoral-popliteal and femoral-crural areas. Femoral-popliteal bypass grafts above the knee joint remained patent in 93% of the p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02393582
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:The optimal timing of VTE prophylaxis initiation after blunt solid organ injury is controversial. Retrospective studies suggest initiation ≤48 h is safe. This prospective study examined the safety and efficacy of early VTE prophylaxis initiation after nonoperative blunt solid organ injury. METHODS:All patie...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05096-7
更新日期:2019-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2315-z
更新日期:2014-04-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9347-1
更新日期:2008-05-01 00:00:00
abstract::Experience with the use of nylon fishing line for surgical sutures has been reported from several African countries. A recent publication suggested that fishing line and an injection needle may provide an atraumatic suture that is especially suitable for intracutaneous skin closures. This article provides further empi...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2004-04-01 00:00:00
abstract::The acid-base balance from the postoperative day (POD) 1 to POD 3 after cirrhotic liver resection was investigated in relation to operative outcome by conducting a retrospective study on the changes in arterial ketone body ratio (AKBR), which reflects the hepatic mitochondrial redox state, and arterial blood gas analy...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01655722
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Roux-en-Y anastomosis is the standard of care for biliary reconstruction. Yet, a direct bilio-biliary anastomosis preserves the normal sphincter mechanism and endoscopic access to the biliary tree for diagnostic and therapeutic purposes. Duct-to-duct biliary reconstruction is widely used in liver transplanta...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1318-x
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:Mechanical bowel obstruction cases constitute an important place in emergency health care services. In this study, bowel obstructions caused by intra-abdominal tumors were compared with those without tumoral causes. PATIENTS AND METHODS:A total of 155 cases of mechanical bowel obstruction diagnosed were r...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0440-z
更新日期:2006-07-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05065-0
更新日期:2019-10-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0707-x
更新日期:2010-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00268-008-9917-x
更新日期:2009-04-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:2013-03-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2014-09-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2012-12-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2015-01-01 00:00:00
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journal_title:World journal of surgery
pub_type: 历史文章,杂志文章
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更新日期:2004-04-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2015-08-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:2020-11-01 00:00:00