It is indeed a a dilemma for many surgeons whether to go ahead with the surgery or not.Laparoscopic cholecystectomy
remains the standard treatment for cholelithiasis
. Ever increasing number of patients with many co- mrbidities are being treated by this technique. However, significant concern prevails among the surgical community regarding its safety in patients with cardiac co-morbidity.
A very large study of such patients was undertaken and it showed that laparoscopic cholecystectomy may be safely performed in patients with significant cardiac dysfunction
. Such patients need proper evaluation by cardiologists and anesthesiologists
If considered safe to undergo general anaesthesia
, such patients should not be denied the benefits of laparoscopic cholecystectomy. Optimization of cardiac status, administration of balanced anaesthesia and low-pressure pneumoperitoneum
are essential steps to ensure patient safety. The chances of life threatening complications are rare, and in the eventuality, can be easily managed in a hospital with adequate cardiological support.
Discuss with a cardiologist and an anaesthetist and abide by their evaluation.