# Feasibility and Safety of Concomitant Laparoscopic Cholecystectomy With Open-Heart Surgery: A Systematic Review and Our Early Clinical Experience

## TL;DR

This paper reviews the safety of performing heart surgery and gallbladder removal at the same time, based on a literature review and two successful patient cases.

## Contribution

The study presents a novel clinical approach combining open-heart surgery with laparoscopic cholecystectomy and reports on its safety and feasibility.

## Key findings

- Two patients successfully underwent combined open-heart surgery and laparoscopic cholecystectomy with uneventful recovery.
- The systematic review found no prior reports of adverse outcomes from this combined surgical approach.
- Concomitant surgery may be a safe option for patients with coexisting cardiac and gallbladder conditions.

## Abstract

Significant valvular or coronary artery disease may co-exist in patients presenting with symptomatic cholelithiasis. Isolated laparoscopic cholecystectomy in these cases is often associated with cardiac complications. Addressing the cardiac condition first may result in flaring up of cholecystitis during postoperative recovery and is associated with adverse outcomes. Open-heart surgery followed by laparoscopic cholecystectomy during a single operative setting is an option in these situations. The aim of our study is to review the published articles for this strategy and to share our initial experience with two such patients.

PubMed, OVID Medline, and Cochrane library database were used, and we searched these databases using Medical Subject Headings (MeSH) terms and keywords from the inception date until August 1, 2023, and did not restrict our search to any language, study type, sample size, or publication date. All the publications reporting concomitant laparoscopic cholecystectomy and open-heart surgery were identified and a systematic review was carried out.

Our first case underwent coronary artery bypass grafting and laparoscopic cholecystectomy. The second patient underwent a double valve replacement and laparoscopic cholecystectomy. Both the patients made an uneventful recovery, and are alive and doing well. Concomitant open-heart surgery and laparoscopic cholecystectomy in certain situations may be necessary and can be performed safely.