Cholecystectomy in patients with hematologic malignancies

Cholecystectomy in patients with hematologic malignancies remains poorly understood. We retrospectively evaluated patients with hematologic malignancies who underwent cholecystectomy at a single institution. Of 313 patients who presented for evaluation of abdominal pain, 64 underwent cholecystectomy for acute cholecystitis (34.4%), gangrenous cholecystitis (21.9%), chronic cholecystitis (23.4%), and cholelithiasis (20%). Most had a history of hematopoietic cell transplantation (62.5%) and/or immunosuppressive medication within 30 days of consultation (82.8%). Ultrasound had a 39% false-negative rate for acute nongangrenous cholecystitis. Operative time was 92 ± 39 min, 7 were performed open, 10 had intraoperative transfusions, and 4 had grade 3+ complications. Intraoperative transfusion was associated with increased postoperative length of stay (p = 0.03). Open procedure, operative time, estimated blood loss, intraoperative transfusion, and complications were not associated with timing of surgery. Patients with hematologic malignancies can safely undergo cholecystectomy. Length of postoperative stay for inpatients is associated with intraoperative blood transfusion. •Ultrasound had a high false-negative rate for acute nongangrenous cholecystitis.•Cholecystectomy in hematologic malignancy patients had a 12.5% complication rate.•6.3% of these were grade III or higher.•Intraoperative transfusion was associated with increased postoperative LOS.