This journal only 2007, Number 1 Rev Mex Cir Endoscop 2007; 8 (1) Hepatomegaly secondary to cardiac insufficiency Rojano RM, Moreno PM, González ML, Pereira GF, León TA Full text How to cite this article Language: Spanish References: 9 Page: 12-15 PDF size: 46.86 Kb. Key words: Laparoscopic, cholecystectomy, chronic disease, cholecystitis, heart failure. ABSTRACT Background: Laparoscopic cholecystectomy has been accepted as the treatment of choice for gallbladder lithiasis. There are special situations that make the execution more difficult and with that the morbimortality increases. Patients and methods: From 2001 to 2004 we studied files of patients with chronic cholecystitis referred to our hospital for cholecystectomy with diagnosis of certain cardiovascular illnesses and heart failures. The measured variables: age, sex, cardiovascular diagnosis, heart failure classification, time of surgery, transoperatory hemorrhage, drainage usage, complications, conversion. We carried out a retrospective observational analysis. Results: 10 patients were found with symptomatic chronic cholecystitis, all of them presented heart failure class I at the moment of surgery, 5 patients with valve replacement for rheumatic heart disease. With all the patients the laparoscopic cholecystectomy could be carried out, finding in all of them hepatomegaly and 2 patients needing endosuture. No further complications. Conclusion: Patients with heart failure and symptomatic chronic cholecystitis, laparoscopic cholecystectomy may be applied trying to avoid hemorrhagic complications and possible variations in the surgical approach in order to adapt to the hepatomegaly. REFERENCES Soper NJ, Stockmann PT, Dunnegan DL et al. Laparoscopic cholecystectomy. The new “gold standard”? Arch Surg 1992; 127: 917-21. Morino M, Cavuoti G, Miglietta C, Giaurudo G, Simone P. Laparoscopic cholecystectomy in cirrhosis: Contraindication or priviliged indication? Surgical Laparoscopy Endoscopy & Percutaneous Techniques 2000; 10: 260-63. Schwartz S. Biliary tract surgery and cirrhosis: A critical combination. Surgery 1981; 90: 577-583. Garrison RN, Cryer HM, Howard DA, Polk HC. Clarification of risk factors for abdominal operations in patients with hepatic cirrhosis. Ann Surg 1984; 199: 648-654. Braunwald E. Heart disease. A textbook of cardiovascular medicine. Fourth Edition: 1992: 452-455. Kogut K, Aragoni T, Ackerman NB. Cholecystectomy in patients with mild cirrhosis. Arch Surg 1985; 120: 1310-11. Ogawa T, Shimizu S, Mizumoto K, Uchiyama A, Yokohata K, Chijiiwa K, Tanaka M. Comparison of laparoscopic versus open cholecystectomy in patient with cardiac valve replacement. J Hepatobiliary Pancreat Surg 2001; 8: 158-60. Clark JR, Wills VL, Hunt DR. Cirrhosis and laparoscopic cholecystectomy. Surgical Laparoscopy Endoscopy & Percutaneous Techniques 2001; 11: 165-169. Tuech JJ, Pessaux P, Regenet N, Rouge C, Bergamaschi R, Arnaund JP. Laparoscopy cholecystectomy in cirrhotic patients. Surgical Laparoscopy Endoscopy & Percutaneous Techniques 2002; 12: 227-231.