Laparoscopic Cholecystectomy in Cirrhotic Patients with Symptomatic Cholelithiasis

摘要

Gallstones are twice as common in cirrhotic patients as in the general population. Laparoscopic cholecystectomy (LC) was originally contraindicated in cirrhotic patients because of the associated portal hypertension and coagulopathy. But nowadays, it is not considered contraindicated. This study examined the safety of LC in Child’s class A-B patients. All the cirrhotic patients with gallstones who underwent LC between September 2008-October 20011 have been included in the study. All the cirrhotic patients with Child-Pugh class A and B cirrhosis undergoing LC were included in the study. Demographic characteristics and other parameters including initial presentation, conversion rate, complication rate, mortality, and duration of hospital stay, timing operative were investigated. 21 patients with Child-Pugh A (76.1%) and Child Pugh B (23.8%), liver cirrhosis, (F/M 4/21) underwent LC. The mean age was approximately 61.1±14 years. Two patients (9.5%) developed postoperative wound infection, and mean hospital stay was 3.8 (2-12) days. Of the 21 cases, 2 (9.5%) were converted to open cholecystectomy. The mean operation time was 82.5±15 minutes. Intra-operative and postoperative complications occurred in 3 patients (14.2%) in the form of liver bed bleeding. LC is a safe and effective alternative for the treatment of symptomatic cholelithiasis in patients with well-compensated Child′s Class A and Class B cirrhosis. The laparoscopic approach offers advantages of less blood loss, shorter operative time, and shorter length of hospitalization in patients with cirrhosis compared to open cholecystectomy.