[Morbidity after video-laparoscopic cholecystectomy in cholelithiasis associated with liver cirrhosis. A case-control...

At present laparoscopic cholecystectomy represents the treatment of choice for symptomatic cholelithiasis. Authors performed a retrospective case-control study to evaluate whether cirrhosis associated with cholelithiasis increases the risk for morbidity of laparoscopic cholecystectomy. Twenty-one patients with cholelithiasis and cirrhosis (Child-Pugh class A or B) (group A) and 21 controls with cholelithiasis without cirrhosis (group B) entered the study. Controls were paired with cases for age, sex, and indication for cholecystectomy (simple cholelithiasis, acute cholecystitis). The two groups were compared for rate of conversion to open cholecystectomy (19% group A vs 9.5% group B; p = 0.31), morbidity (29.5% group A vs 5.3% group B; p = 0.17), median length of surgery (80 m in the two groups), and median time of postoperative hospitalization (5 days group A vs 3 days group B; p = 0.21). No difference among variables resulted to be statistically significant. Besides, neither common bile duct injuries nor intra or postoperative hemorrhages occurred in patients with cirrhosis. Authors conclude that the laparoscopic cholecystectomy can be considered a safe and effective surgical procedure also for patients with cholelithiasis associated with cirrhosis with a good residual hepatic function.