Emergency laparoscopic cholecystectomy for a patient with an implantable left ventricular assist device: report of a case

It is not uncommon for cardiac surgery to be complicated by postoperative acute cholecystitis. We recently performed laparoscopic cholecystectomy for severe acute cholecystitis, which developed after the implantation of a left ventricular assist device (LVAD) for dilated cardiomyopathy in a 31-year-old man. The LVAD is an accepted bridging treatment to heart transplantation. With the patient under general anesthesia, we made landmarks around the LVAD and a drive-line to prevent injury by trocar insertion. The first port was inserted in the umbilicus and because the subxyphoid space was occupied, the second trocar was inserted in the left flank and the other two trocars were inserted in the right subcostal area. The operation time was 160 min and the estimated blood loss was 430 ml. The patient had an uneventful postoperative course. Thus, concomitant cholecystectomy should be considered when installing an LVAD system if the patient has biliary abnormalities.