Key result
Direct surgical manipulation of the gallbladder during laparoscopic cholecystectomy triggered coronary artery spasm with ST-segment elevation and ventricular tachycardia in a 44-year-old man.
Why the study?
While the link between cholecystitis and acute coronary syndrome-like symptoms is known, it remains unclear whether these symptoms can be provoked by direct stimulation to the gallbladder.
Does surgical gallbladder manipulation trigger coronary artery spasm in a patient undergoing laparoscopic cholecystectomy?
Case Report (n=1)
Does surgical gallbladder manipulation trigger coronary artery spasm in a patient undergoing laparoscopic cholecystectomy?
Direct surgical manipulation of the gallbladder during laparoscopic cholecystectomy can trigger coronary artery spasm and ventricular arrhythmias, necessitating careful ECG monitoring.
Although the association between cholecystitis and acute coronary syndrome-like symptoms, including chest pain with electrocardiogram (ECG) changes, has been reported previously, it is unclear whether these symptoms can be provoked by direct stimulation to the gallbladder. We present the case of a 44-year-old man who developed coronary artery spasm (CAS) with ST-segment-elevation followed by nonsustained polymorphic ventricular tachycardia during laparoscopic cholecystectomy. The change in ECG occurred only when the gallbladder was manipulated, suggesting that direct stimulation to the gallbladder can cause CAS. Clinicians should be aware that careful ECG monitoring is necessary, especially while the gallbladder is manipulated.
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Nakayama et al. (2020) conducted a case report in Coronary artery spasm during laparoscopic cholecystectomy (n=1). Surgical gallbladder manipulation was evaluated on Coronary artery spasm with ST-segment-elevation and nonsustained polymorphic ventricular tachycardia. Direct surgical manipulation of the gallbladder during laparoscopic cholecystectomy triggered coronary artery spasm with ST-segment elevation and ventricular tachycardia in a 44-year-old man.
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