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Risk Assessment of Laparoscopic Cholecystectomy in Liver Cirrhotic Patients with Clinically Significant Portal

Hao-Yang Tan1, Jun-Fei Gong1, Wen-Hao Tang2

  • 1Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|July 23, 2019
PubMed

Insights

Clinically significant portal hypertension (CSPH) did not increase postoperative complications in cirrhotic patients undergoing laparoscopic cholecystectomy. However, CSPH prolonged hospitalization and increased conversion rates, with MELD score and operative factors being key predictors.

Area of Science:

  • Hepatology
  • Gastroenterology
  • Surgical Oncology

Background:

  • Cirrhosis often leads to clinically significant portal hypertension (CSPH).
  • The impact of CSPH on postoperative outcomes following laparoscopic cholecystectomy (LC) in cirrhotic patients requires further clarification.
  • Identifying risk predictors for complications is crucial for patient management.

Purpose of the Study:

  • To evaluate the correlation between CSPH and postoperative complications in cirrhotic patients undergoing LC.
  • To identify potential risk predictors for postoperative complications in cirrhotic patients with CSPH.

Main Methods:

  • Retrospective study design.
  • Division of cirrhotic patients into two groups: with and without CSPH.
  • Multivariate logistic regression analysis to determine risk predictors.

Main Results:

  • Patients with CSPH experienced prolonged postoperative hospitalization but no significant difference in complication incidence compared to those without CSPH.
  • Key risk predictors for postoperative complications included male gender, gallbladder wall thickness >3 mm, gallstone size ≥1 cm, Model for End-Stage Liver Disease (MELD) score ≥10, and operation time >60 minutes.
  • CSPH was associated with increased conversion rates during LC.

Conclusions:

  • CSPH does not elevate the incidence of postoperative complications in cirrhotic patients undergoing LC.
  • CSPH is linked to increased conversion rates and extended hospital stays.
  • Gender, gallbladder wall and stone size, MELD score, and operation duration are significant predictors of postoperative complications in cirrhotic patients with CSPH.

Keywords:
cirrhotic patientsclinically significant portal hypertensionlaparoscopic cholecystectomypostoperative complicationsrisk predictors

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