Laparoscopic cholecystectomy in cirrhotic patients with symptomatic gallstone disease.
BACKGROUND
The aim of this study was to evaluate the outcome in patients with liver cirrhosis who underwent laparoscopic cholecystectomy for symptomatic gallstone disease.


METHODS
Retrospective analysis of prospectively collected data of 34 patients operated between March 1998 and April 2006.


RESULTS
There were 19 male and 15 female patients with a median age of 62 years. Cirrhosis aetiology was viral hepatitis in 25 patients, alcohol in 6, primary biliary cirrhosis in 2 and in 1 patient the cause was not identified. Twenty-three were classified as Child-Pugh-Turcotte stage A and 11 as Child-Pugh-Turcotte stage B. The median Model For End-Stage Liver Disease score was 12. Median operating time was 96 min. In three patients there was conversion to open cholecystectomy. Postoperatively, one patient died and six more patients had complications. Median postoperative stay was 3 days. Patients with acute cholecystitis did not have increased morbidity, but had significantly longer hospital stay.


CONCLUSIONS
Laparoscopic cholecystectomy can be carried out with acceptable morbidity in selected patients with well-compensated Child A and B stages liver cirrhosis. Patients with evidence of significant portal hypertension and severe coagulopathy should avoid surgery.
Leandros
Emmanuel
E
Department of Surgery, University of Athens, Hippocration Hospital, Athens, Greece. eleandro@med.uoa.gr
Albanopoulos
Konstandinos
K
Tsigris
Christos
C
Archontovasilis
Fotios
F
Panoussopoulos
Sotirios G
SG
Skalistira
Maria
M
Bramis
Costas
C
Konstandoulakis
Manousos M
MM
Giannopoulos
Athanasios
A
D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D005260:Female; D042882:Gallstones / Q000150:complications / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome