Laparoscopic cholecystectomy in cirrhotic patients.
BACKGROUND
This study aimed to evaluate the safety of laparoscopic cholecystectomy for patients with cirrhosis.


METHODS
The records of 22 laparoscopic cholecystectomies performed in patients with cirrhosis Child-Pugh A and B, from January 1995 to July 2001 were retrospectively reviewed.


RESULTS
No deaths occurred. Conversion to open cholecystectomy was necessary in two cases. The average operative time was 115 min, which was significantly shorter than that for patients undergoing open cholecystectomy. None of the patients required blood transfusion. Intraoperative problems occurred in two patients who experienced liver bed bleeding. Postoperative morbidity occurred in 36% of the patients and included hemorrhage, wound complications, intraabdominal collections, and cardiopulmonary complications, but all were controlled. The patients were dismissed after an average of 4 days.


CONCLUSIONS
The authors believe laparoscopic cholecystectomy can be performed safely in selected patients with cirrhosis Child-Pugh A and B who manifest indication for surgery. Laparoscopic cholecystectomy offers several advantages over open cholecystectomy: lower morbidity, shorter operative time, and reduced hospital stay.
Department of Surgery, University of Messina, Policlinico G.Martino, Messina, Italy. ecucinot@unime.it
E
E
Cucinotta
S
S
Lazzara
G
G
Melita
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000150:complications / Q000601:surgery*; D003097:Collateral Circulation; D015897:Comorbidity; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014472:Umbilicus