Laparoscopic Cholecystectomy After Coronary Artery Bypass Grafting Using the Right Gastroepiploic Artery: Report of a Case

Autor: Kazuhiro Sakamoto, Shigeru Shirota, Shigeru Kobayashi, Masahiko Tsurumaru, Toshiki Kamano, Kenji Takazawa, Tsuyoshi Okada, Yuichi Tomiki, Mitsuhiro Matsuda, Suguru Watabe, Yoshifumi Lee, Masayuki Kitajima
Rok vydání: 2002
Předmět:
Zdroj: Surgery Today. 32:840-843
ISSN: 1436-2813
0941-1291
DOI: 10.1007/s005950200164
Popis: A laparoscopic cholecystectomy (LC) was successfully performed on a 61-year-old man who had undergone coronary artery bypass grafting (CABG) using the right gastroepiploic artery (RGEA). He complained of right hypochondralgia 20 days after CABG. Gallstones were diagnosed and a cholecystectomy was performed 9 months after CABG. Under general anesthesia, the operation was performed using a pneumoperitonium. When a laparoscope was inserted, the RGEA pedicle could be clearly recognized. The pedicle obstructed the operating field and made the working space narrower than usual. No ST changes on the electrocardiogram were seen during LC, especially during the initiation of pneumoperitonium, the insertion of the ports, or when retracting the gallbladder. The postoperative course was uneventful. To avoid complications, care should be taken not to stretch the RGEA pedicle during LC, and careful monitoring of the electrocardiogram is also necessary. It is difficult to view the operating field and the RGEA pedicle together. It is therefore better to insert another laparoscope for concomitant monitoring of the RGEA pedicle.
Databáze: OpenAIRE
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