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Laparoscopic treatment of cholelithiasis in cirrhotic patients
M Flores Cortés1, A Obispo Entrenas, F Docobo Durántez
1Department of General and Gastrointestinal Surgery, University Hospital Virgen del Rocío, Seville, Spain.
Insights
Laparoscopic cholecystectomy is safe for gallstones in Child
Area of Science:
- Hepatology
- Gastroenterology
- Surgical Innovation
Background:
- Symptomatic cholelithiasis poses a risk in patients with liver cirrhosis.
- Child's Class A and B cirrhosis represent well-compensated liver disease.
- Surgical options for cholelithiasis in cirrhotic patients require careful consideration.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic cholecystectomy.
- To assess outcomes in patients with Child's Class A and B cirrhosis.
Main Methods:
- Retrospective descriptive study.
- Analysis of 14 patients with Child's Class A/B cirrhosis undergoing laparoscopic cholecystectomy.
- Evaluation of intraoperative and postoperative complications.
Main Results:
- Average surgery duration was 77 minutes.
- Intraoperative bleeding occurred in 2 patients (14.28%).
- Postoperative complications (ascites, chest pain) in 3 patients (21.42%); no mortality or conversions.
Conclusions:
- Laparoscopic cholecystectomy is a safe and effective treatment for gallstones in Child's Class A/B cirrhosis.
- Low postoperative morbidity and mortality.
- Short surgical duration and hospital stay observed.
Objective:
To assess the safety and efficacy of laparoscopy in the treatment of symptomatic cholelithiasis in patients with Child's Class A and Class B cirrhosis.
Study Design:
Descriptive and retrospective study.
Patients:
We studied 14 patients (mean age 60 yrs) with Child's Class A and Class B hepatic cirrhosis who underwent laparoscopic cholecystectomy. We analyzed the occurrence of intraoperative and postoperative complications.
Results:
Eight patients were women (57.14%) and 6 were men (42.85%). Eight of the 14 patients presented with Child's Class B cirrhosis and 6 patients with Class A. Cholecystectomy was programmed for all patients. The average duration of surgery was 77 min. Intraoperative complications occurred in 2 patients (14.28%) in the form of liver bed bleeding. Postoperative complications were observed in 3 patients (21.42%), 2 presented with ascites which led to a worsening of Child's Class in one of them, and the third patient presented with angina-like symptoms (acute, sharp pain in the chest irradiating to the back). Mean length of hospital stay was 3 days. No postoperative morbidity or mortality occurred, and there were no conversions.
Conclusions:
LC (laparoscopic cholecystectomy) 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. Postoperative morbi-mortality is low, bleeding is unimportant, and both duration of surgical procedure and hospital stay are short.