A comparison of open and laparoscopic cholecystectomy for patients with cirrhosis.
To evaluate the benefits of performing laparoscopic cholecystectomy (LC) in patients with cirrhosis, data on 13 patients with liver cirrhosis who underwent cholecystectomy for gallstones between 1989 and 1995 were retrospectively collected from charts filed at Fukuoka City Hospital. These 13 patients were classified into two groups; one, comprised of 7 who underwent LC, and another, comprised of 6 who underwent open cholecystectomy (OC). No statistical differences were observed in the duration of surgery or the intraoperative blood loss between the two groups; however, the C-reactive protein (CRP) level in the serum was significantly higher in the OC group than in the LC group. LC was followed by a significantly earlier resumption of a normal diet (P < 0.05) and a shorter hospital stay (P < 0.05) in comparison to OC. All of the patients who underwent OC had an uneventful clinical course; however, one of the patients who underwent LC suffered from intractable ascites postoperatively. The difference in the cost of hospitalization between the two groups was not statistically significant. These findings suggest that the therapeutic significance of performing LC in patients with cirrhosis should be assessed after carefully evaluating all factors including mortality, morbidity, and cost-effectiveness. Thus, further controlled trials are necessary.
Saeki
H
H
Department of Surgery, Fukuoka City Hospital, Japan.
Korenaga
D
D
Yamaga
H
H
Mawatari
K
K
Orita
H
H
Itasaka
H
H
Yano
K
K
Maekawa
S
S
Muto
Y
Y
Ikeda
T
T
Sugimachi
K
K
D000368:Aged; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic / Q000191:economics; D002769:Cholelithiasis / Q000453:epidemiology / Q000601:surgery*; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies