Cirrhosis is not a contraindication to laparoscopic cholecystectomy: results and practical recommendations. HPB (Oxford) 2011 Mar;13(3):192-7
Date
02/12/2011Pubmed ID
21309937Pubmed Central ID
PMC3048971DOI
10.1111/j.1477-2574.2010.00270.xScopus ID
2-s2.0-79951674383 (requires institutional sign-in at Scopus site) 32 CitationsAbstract
BACKGROUND: Gallstones appear more frequently in patients with cirrhosis and open cholecystectomy in this patient population is associated with higher morbidity and mortality. The aim of the present study was to evaluate experience with laparoscopic cholecystectomy in patients with cirrhosis and to provide recommendations for management.
METHODS: Retrospective review of laparoscopic cholecystectomy in patients with cirrhosis from March 1999 to May 2008 was performed. Peri-operative characteristics and subgroup analysis were performed in patients with Child-Pugh's classes A, B and C cirrhosis.
RESULTS: A total of 68 patients were reviewed in this study. In all, 69% of the patients were Child's class A. The most common indication for cholecystectomy was chronic/symptomatic cholelithiasis (68%). Compared with patients with Child's class B and C, laparoscopic cholecystectomy in patients with Child's class A was associated with significantly decreased operative time (P= 0.01), blood loss (P= 0.001), conversion to open cholecystectomy (P= 0.001) and length of hospital stay (P= 0.001).
CONCLUSIONS: Laparoscopic cholecystectomy in patients with cirrhosis is feasible with no mortality and low morbidity, especially in patients with Child's class A cirrhosis.
Author List
Nguyen KT, Kitisin K, Steel J, Jeyabalan G, Aggarwal S, Geller DA, Gamblin TCAuthor
Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Blood Loss, Surgical
Cholecystectomy, Laparoscopic
Cholelithiasis
Contraindications
Female
Humans
Length of Stay
Liver Cirrhosis
Male
Middle Aged
Morbidity
Retrospective Studies
Treatment Outcome
Young Adult
