Laparoscopic cholecystectomy in cirrhotic patients with symptomatic cholelithiasis: a case-control study.
BACKGROUND
In this study we retrospectively evaluated a group of symptomatic cirrhotic (n=30) and non-cirrhotic (n=60) patients submitted to laparoscopic cholecystectomy (LC) in a public hospital in Brazil.


METHODS
The groups were compared for surgical time, duration of hospitalization after surgery, period of permanence in the intensive care unit (ICU), use of blood derivatives, mortality rates, and transoperative and post-surgery complications. Other parameters, such as hepatic reserve capacity and presence of ascites, were also analyzed.


RESULTS
Twenty-three (76.7%) of the patients of the cirrhosis group (CG) were classified as Child-Pugh A, and seven (23.3%) were Child-Pugh B. Six of them (20%) had ascites. Differences between the two groups included surgery time (p=0.008), duration of hospitalization (p=0.014), and post-surgery (p=0.000) or ambulatory (p=0.008) complications. The worst results were observed among Child B patients and in those with ascites. Blood derivatives were used in only 3.3% of the CG patients. No cases of conversion to laparotomy were observed among the two groups of patients included in this study, nor were there any deaths.


CONCLUSIONS
These results indicate that videolaparoscopic cholecystectomy may be safely performed in public hospitals in Brazil, with low levels of complications, no associated mortality, and no need for blood derivatives.
Department of General and Transplantation Surgery, Hospital Beneficência Portuguesa, São Paulo, SP, Brazil.
Jorge Marcelo Padilla
JM
Mancero
Luiz Augusto Carneiro
LA
D'Albuquerque
Adriano Miziara
AM
Gonzalez
Frans Ivan Serpa
FI
Larrea
Adavio
A
de Oliveira e Silva
D001938:Brazil; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D003906:Developing Countries; D005260:Female; D006769:Hospitals, General; D006779:Hospitals, Public; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome