FORUM MŁODYCH CHIRURGÓW
Cardiac surgery with extracorporeal circulation in children − another factor of the gallbladder oedema?

The purpose of this study was to assess ultrasound image of the gallbladder after cardiac surgery in extracorporeal circulation of congenital heart disease in children.

Among 73 examinated children, thirty-eight children were included to analysis. They were patients of the Department of Paediatric Cardiac Surgery in Gdansk (age range: 5 days –

6 years; average: 14,5 months), who were qualified for cardiac surgery with extracorporeal circulation from September 2009 to April 2010. This group underwent sonography of the gallbladder thrice, a day before surgery, in the first and the second day after surgery.

All patients had no abnormalities in ultrasound image of the gallbladder before cardiac surgery. Thirty-five (92%) of the 38 patients were found to have thickening of the gallbladder wall (thickness range: 4-20 mm; average: 7.9 mm) in the first day after surgery. In the second day after surgery, the thickening decreased of 0.2-6.7mm (average: 1.74 mm) in

12 (34%) of 35 patients with thickened gallbladder wall in the first day, however, it was still higher than reference range

(< 3 mm). Twenty-one (60%) of the 35 had the normal thickness in the second day. In two cases there were increase in the thickness, from 8.5 mm to 10 mm and form 5.7 mm to 6.2 mm. Hypoalbuminemia was excluded in all cases. There was no statistically significant correlation between inflamation factors and aorta cross-clamp time.

Cardiac surgery with extracorporeal circulation in children is another clinical condition, which has to be taken into consideration in differential diagnosis of the thickening of the gallbladder wall.