Perioperative management and surgical outcomes of laparoscopic cholecystectomy in heart or lung transplant patients

Abstract

The optimal management of cholecystitis or cholelithiasis after organ transplant is unclear. In this study, ten patients with medical history of heart or lung transplant underwent laparoscopic cholecystectomy in our hospital, and the perioperative managements and surgical outcomes were retrospectively analyzed. The mean age of these patients was 47 years. The transplanted organs were heart (n=8) and lung (n=2). The indications of laparoscopic cholecystectomy were chronic cholecystitis (n=6), common bile duct stones (n=3), symptomatic cholelithiasis (n=2) and acute cholecystitis (n=2). All patients received elective laparoscopic surgery. The operative procedures were multi-ports surgery (n=9) and single-port (n=1). There were no patients with conversion to open surgery. The immunosuppressive regimens consisted of 3 agents (n=9) and 4 agents (n=1), and the main regimen was the combination of cyclosporine or tacrolimus and prednisolone plus mycophenolate mofetil. Eight patients took the immunosuppressive agents in the morning of surgery and 10 patients resumed the baseline immunosuppressive regimen in the evening after surgery. The trough level was monitored in all patients and 5 patients needed to adjust the dose of immunosuppressive agent. All patients discharged without the complications of infection or rejection of the transplanted organs. Elective laparoscopic cholecystectomy for heart or lung transplant recipients were safely conducted without any complications by perioperatively continuing immunosuppressive agents.