Laparoscopic cholecystectomy in cirrhotic patients.
OBJECTIVE
Laparoscopic cholecystectomy has become the procedure of choice for symptomatic cholelithiasis. A study to evaluate the benefits and risks of laparoscopic cholecystectomy in cirrhotic patients was performed.


METHODS
Between January 1994 and December 2000, 1,100 laparoscopic cholecystectomies for symptomatic gallbladder diseases were performed. There were 24 cirrhotic patients (group A) and 72 age- and sex-matched controls (group B). All patients had well-compensated cirrhosis (Child's class A or B).


RESULTS
There was no operative mortality in either group and the postoperative complication rates were 20.8 and 9.72% in groups A and B, respectively (p < 0.000001). Operative time in group A was 89.16 vs. 68.41 min in group B (p < 0.000001). The estimated intraoperative blood loss in group A was 106.25 vs. 37.08 ml in group B (p < 0.000001). The average transfusion requirement was 0.155 and 0.0 units in groups A and B, respectively (p < 0.025). The hospital stay in groups A and B was 4.7 and 3.61 days, respectively (p < 0.0500).


CONCLUSIONS
Laparoscopic cholecystectomy in patients with compensated cirrhosis is safe and should be the treatment of choice for these patients. Laparotomy should be applied only if the surgeon considers the operation inadequate to be continued laparoscopically.
Leone
N
N
Department of Gastroenterology, Molinette Hospital, Turin, Italy. leone.nic@tiscalinet.it
Garino
M
M
De Paolis
P
P
Pellicano
R
R
Fronda
G R
GR
Rizzetto
M
M
D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged