Abstract
We encountered 2 cases of acute cholecystitis in which the condition developed after coronary artery bypass grafting (hereinafter, CABG) using the right gastroepiploic artery (hereinafter, RGEA). Case 1 was a 70-year-old male who was diagnosed as having perforated acalculous cholecystitis, and emergency abdominal surgery was performed after first confirming running RGEA grafted blood vessels upon blood flow in the grafted RGEA by CT imaging. Case 2 was a 72-year-old male who underwent conservative therapy after being diagnosed as having mild acute cholecystitis. Running RGEA grafted blood vessels were Blood flow in the grafted RGEA was confirmed by vascular reconstruction 3D-CT, and laparoscopic surgery was electively performed. In both cases, RGEA grafted blood vessels blood flow in the grafted RGEA was intraoperatively confirmed with no injuries, and the patients were discharged from the hospital with no complications. It was possible to perform cholecystectomy by either laparotomy or laparoscopic surgery; however, considering that it is invasive and allows safe confirmation of the blood flow in the grafted blood vessels, it is believed that endoscopic surgery would be highly advantageous. With respect to acute cholecystitis following CABG using an RGEA graft, it is believed that further safety can be ensured by avoiding emergency surgery in such cases as much as possible and performing surgery after sufficient preoperative planning.
