Key result
Laparoscopic cholecystectomy linked to ~226% more transient ECG changes in patients without prior cardiac disease.
Why the study?
The potential impact of laparoscopic cholecystectomy on postoperative ECG changes in patients without pre-existing cardiovascular disease remains unclear.
Does laparoscopic cholecystectomy induce de novo ECG changes in patients with acute cholecystitis and no prior cardiac disease?
Cohort (n=75)
No
Does laparoscopic cholecystectomy induce de novo ECG changes in patients with acute cholecystitis and no prior cardiac disease?
Absolute Event Rate: 17.3% vs 5.3%
p-value: p=0.012
Laparoscopic cholecystectomy is associated with transient, benign de novo ECG changes in patients without prior cardiac disease, suggesting post-operative ECGs should be interpreted with caution.
Background & Aims: Acute cholecystitis, primarily an inflammatory condition of the gallbladder, has been associated with electrocardiographic (ECG) changes that mimic cardiac pathology.While laparoscopic cholecystectomy is a well-established treatment for acute cholecystitis, its potential impact on postoperative ECG changes in patients without pre-existing cardiovascular disease remains unclear.This study aims to investigate the incidence and nature of ECG alterations following laparoscopic cholecystectomy in patients without prior cardiac disease. Materials & Methods:In this single-arm cohort study, we reviewed 75 patients who underwent laparoscopic cholecystectomy for acute cholecystitis at Firouzabadi General Hospital between March 2020 and March 2021.Patients with pre-existing cardiac conditions or abnormal preoperative ECGs were excluded.A 12-lead ECG was performed within 48 hours before and 24 hours after surgery.ECGs were analyzed by a cardiologist and an internist, and discrepancies were resolved through consensus.The difference in the incidence of postoperative ECG changes was assessed using McNemar's Chi-Square test.Results: Among the 75 patients included (mean age: 47.38 13.16 years, 74.7% female), four patients (5.3%) had benign T-wave inversions before surgery.Following surgery, 13 patients (17.3%) exhibited new ECG changes, including T-wave inversions (precordial: 5, limb leads: 5) and ST-segment depressions (precordial: 1, limb leads: 2).McNemar's Chi-Square test indicated a statistically significant increase in ECG changes postoperatively (p = 0.012).All patients were discharged without persistent ECG abnormalities or major postoperative complications. Conclusion:This study suggests a potential association between laparoscopic cholecystectomy and transient ECG alterations in patients without prior cardiac disease.Proposed mechanisms include gallbladder manipulation, sympathetic adrenergic stimulation, and laparoscopy-induced hemodynamic stress.Future studies with larger cohorts and control groups undergoing non-biliary laparoscopic surgeries are needed to delineate the effects of cholecystectomy from those of laparoscopy itself on cardiac electrophysiology.
No takes yet. Share an insight, caveat, or question.
Rajabi et al. (2025) conducted a cohort in Acute cholecystitis (n=75). Laparoscopic cholecystectomy vs. Preoperative baseline was evaluated on Incidence of new ECG changes (T-wave inversions and ST-segment depressions) (p=0.012). Laparoscopic cholecystectomy significantly increased the incidence of transient ECG changes from 5.3% preoperatively to 17.3% postoperatively in patients without prior cardiac disease.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: