Laparoscopic versus open cholecystectomy in cirrhotic patients: a prospective study

• Published in: Surgical laparoscopy & endoscopy Vol. 7; no. 6; p. 483
• Main Authors: Yerdel, M A, Koksoy, C, Aras, N, Orita, K
• Format: Journal Article
• Language: English
• Published: United States 01.12.1997
• Subjects: Blood Loss, Surgical; Cholecystectomy - methods; Cholecystectomy, Laparoscopic; Cholelithiasis - complications; Cholelithiasis - surgery; Contraindications; Female; Humans; Length of Stay; Liver Cirrhosis - complications; Liver Cirrhosis - surgery; Male; Prospective Studies
• ISSN: 1051-7200
• DOI: 10.1097/00019509-199712000-00011

The results of open cholecystectomy ([OC] n = 7) versus laparoscopic cholecystectomy ([LC] n = 7) in cirrhotic patients were analyzed prospectively. Groups were well matched for surgical indication, presence of ascites/bleeding tendency, and Child's grade. There was no mortality. Mean operating time was significantly longer in the LC group (155 +/- 47 vs. 103 +/- 25 min, p < 0.05). Operative blood loss was significantly greater in the OC group (128 +/- 125 vs. 642 +/- 467 ml, p < 0.05). No patient in LC group required blood transfusion in contrast to three patients in OC group. Compared with 0% postoperative complications in LC group, wound infections developed in 43% of the patients in OC group (p < 0.05). Mean hospital stay in LC group was significantly less (6.7 +/- 4 vs. 17.4 +/- 7.3 days, p < 0.01). Thus, contrary to previous belief, cirrhosis per se is not a contraindication to LC. Laparoscopic cholecystectomy may be the procedure of choice whenever cholecystectomy is indicated in a cirrhotic patient because it may be associated with less bleeding and fewer incision-related complications.