Related Experiment Video
Updated: Aug 18, 2026
Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
Laparoscopic cholecystectomy in patients with hepatic cirrhosis: a five-year experience
1Department of Surgery, Beth-Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Insights
Laparoscopic cholecystectomy is safe and effective for patients with early, well-compensated cirrhosis (Child
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Gastroenterology
Background:
- Tertiary referral centers specialize in complex hepatobiliary procedures.
- Laparoscopic cholecystectomy is a common surgical intervention.
- Cirrhosis poses unique challenges in abdominal surgery.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic cholecystectomy in cirrhotic patients.
- To determine the conversion rate from laparoscopic to open surgery.
- To assess outcomes based on procedure urgency.
Main Methods:
- Retrospective analysis of cirrhotic patients undergoing attempted laparoscopic cholecystectomy (1991-1996).
- Inclusion criteria: early, well-compensated cirrhosis (Child's class A or B).
- Data collected on conversion rates, complications, and length of stay.
Main Results:
- Overall conversion rate was 17% (5/30 patients).
- Elective cases had a 5% conversion rate vs. 36% for urgent cases.
- No operative deaths; complication rates were 16% (elective) and 36% (urgent).
Conclusions:
- Laparoscopic cholecystectomy is a safe treatment option for selected cirrhotic patients.
- Early, well-compensated cirrhosis (Child's A or B) is suitable for this approach.
- Procedure urgency impacts conversion rates and complication risk.
Abstract:
Our institution is a tertiary referral center that specializes in hepatobiliary surgery. To evaluate the safety, efficacy, and conversion rate of laparoscopic cholecystectomy in patients with hepatic cirrhosis, we conducted a retrospective analysis of all cirrhotic patients undergoing attempted laparoscopic cholecystectomy during the period from 1991 to 1996. The diagnosis of cirrhosis was made on the basis of either a preoperative history, a liver biopsy, or the surgeon's operative description of the liver. All patients had early, well-compensated cirrhosis (Child's class A or B). A total of 30 patients underwent attempted laparoscopic cholecystectomy and five patients were converted to an open procedure (17%). The conversion rate for elective cases was 5% compared with 36% for urgent procedures. Two patients were converted because of varices and three because of unclear anatomy. No patients were converted because of bleeding. There were no operative deaths. The complication rate for elective procedures was 16%, with an average length of stay of 2.1 days, compared with 36% and 4.8 days, respectively, for urgent cases. Laparoscopic cholecystectomy in patients with early, well-compensated cirrhosis is safe and should be the treatment of choice for these patients.
