[Laparoscopic cholecystectomy in pacients with child's class A cirrhosis of the liver and acute cholecystitis due to cholelithiasis].
Cholecystectomy in cirrhotic patients has been reserved for patients with severe biliary disease, because of the high morbidity and mortality in cirrhotic patients undergoing this procedure. Laparoscopic cholecystectomy (LC) was originally contraindicated in cirrhotic patients because of the associated portal hypertension and coagulopathy.


METHODS
This study examined the safety of LC in Child's class A patients and acute cholecystitis due to cholelithiasis in patients from "Sf. Ioan" Emergency Hospital Iaşi. The studied period was January 2001 - December 2005. Ten patients with cirrhosis had their gallbladder removed laparoscopically during that time period. All patients were Child's class A.


RESULTS
The average age was 62,5 (range, 56-68). The operative indication was acute cholecystitis. Three patients were previously diagnosed with cirrhosis, and 7 were diagnosed intraoperatively. None of the patients required a blood transfusion. No intraoperative or postoperative complications occurred. No deaths occurred. Postoperative stay was 5.8 days. These results compare favorably to other published studies from international literature.


CONCLUSIONS
Based on our findings, we believe LC can be performed safely in patients with class A cirrhosis.
Vasincu
D
D
Clinica de Chirurgie, Spitalul Clinic de Urgenţe "Sf. Ioan" Iaşi.
Mihalache
St
S
Bogza
Geanina
G
D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000209:etiology* / Q000601:surgery*; D002769:Cholelithiasis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000145:classification / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome