title: Cirrhosis is not a contraindication to laparoscopic cholecystectomy: results and practical recommendations.
abstract: BACKGROUND
  Gallstones appear more frequently in patients with cirrhosis and open cholecystectomy in this patient population is associated with higher morbidity and mortality. The aim of the present study was to evaluate experience with laparoscopic cholecystectomy in patients with cirrhosis and to provide recommendations for management.
  
  
  METHODS
  Retrospective review of laparoscopic cholecystectomy in patients with cirrhosis from March 1999 to May 2008 was performed. Peri-operative characteristics and subgroup analysis were performed in patients with Child-Pugh's classes A, B and C cirrhosis.
  
  
  RESULTS
  A total of 68 patients were reviewed in this study. In all, 69% of the patients were Child's class A. The most common indication for cholecystectomy was chronic/symptomatic cholelithiasis (68%). Compared with patients with Child's class B and C, laparoscopic cholecystectomy in patients with Child's class A was associated with significantly decreased operative time (P= 0.01), blood loss (P= 0.001), conversion to open cholecystectomy (P= 0.001) and length of hospital stay (P= 0.001).
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy in patients with cirrhosis is feasible with no mortality and low morbidity, especially in patients with Child's class A cirrhosis.
authors.affiliation: Division of Transplantation, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Kevin Tri
authors.initials: KT
authors.lastname: Nguyen
authors.forename: Krit
authors.initials: K
authors.lastname: Kitisin
authors.forename: Jennifer
authors.initials: J
authors.lastname: Steel
authors.forename: Geetha
authors.initials: G
authors.lastname: Jeyabalan
authors.forename: Shushma
authors.initials: S
authors.lastname: Aggarwal
authors.forename: David A
authors.initials: DA
authors.lastname: Geller
authors.forename: T Clark
authors.initials: TC
authors.lastname: Gamblin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000401:mortality; D017081:Cholecystectomy, Laparoscopic / Q000379:methods / Q000401:mortality; D002769:Cholelithiasis / Q000401:mortality* / Q000601:surgery*; D000075202:Contraindications; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008103:Liver Cirrhosis / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult