Abstract
Background: The results of laparoscopic cholecystectomy in a group of transplant recipients were reviewed to determine the safety and efficacy of the procedure in the setting of immunosuppression.
Methods: All solid-organ-transplant recipients who underwent laparoscopic cholecystectomy over a 3-year period were reviewed. Indication for operation, conversion to open procedure, length of stay, and complications were characterized. These results were compared to the registry data of all laparoscopic cholecystectomies performed at the same institution.
Results: There were 26 transplant patients who underwent laparoscopic cholecystectomy including renal, heart, double lung, and heart-lung recipients. The mean age was 47 years. Symptomatic cholelithiasis was the most common indication in 73% of patients followed by acute cholecystitis in 11%. Seven patients (27%) underwent conversion to an open procedure. Three patients (11.5%) experienced a minor complication in hospital. Median length of stay was 2.5 days. One patient died during a subsequent unrelated operation. These results compared favorably to the registry experience at the same institution where the mean age was 49 years, 24% of cases were performed for acute cholecystitis, there was a 10% complication rate, median length of stay was 2 days, and 3 deaths occurred in hospital. The only statistically significant difference was a lower conversion rate (11% vs 27%) in the registry vs transplant group.
Conclusions: This experience confirms that laparoscopic cholecystectomy is as safe in the transplant population as the general population. Despite a slightly higher conversion rate to an open procedure, the advantages of short hospital stay, low morbidity, and early return to preoperative routines remain equivalent.
Similar content being viewed by others
References
Augustine S, Yeo C, Buchman T, Achuff S, Baumgartner W (1991) Gastrointestinal complications in heart and heart-lung transplant patients. J Heart Lung Transplant 10(4): 547–555
Cadranel JF, Erlinger S, Desruenne M (1992) Chronic administration of cyclosporine A induces a decrease in hepatic excretory function in man. Dig Dis Sci 37(10): 1473–1476
Delorio T, Thompson A, Larson GM, Bentley FR, Miller F (1993) Laparoscopic cholecystectomy in transplant patients. Surg Endosc 7(5): 404–407
Hudson H, Hakaim A, Birkett D (1992) Laparoscopic cholecystectomy in a renal transplant recipient. Surg Endosc 6: 193–194
Penn I, Groth C, Brettschneider L, Martin A, Marchioro T, Starzl T (1968) Surgically correctable intra-abdominal complications before and after renal homotransplantation. Ann Surg 168(5): 865–870
Sekela M, Hutchins D, Young J, Noon G (1991) Biliary surgery after cardiac transplantation. Arch Surg 126: 571–573
Steck T, Costanzo-Nordin MR, Keshavarzian A (1991) Prevalence and management of choletlithiasis in heart transplant patients. J Heart Lung Transplant 10(6): 1029–1032
Steed D, Brown B, Reilly J, Peitzman A, Griffith B, Hardesty R, Webster M (1985) General surgical complications in heart and heart-lung transplantation. Surgery 98(4): 739–744
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Courcoulas, A.P., Kelly, E. & Harbrecht, B.G. Laparoscopic cholecystectomy in the transplant population. Surg Endosc 10, 516–519 (1996). https://doi.org/10.1007/BF00188398
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00188398