Laparoscopic cholecystectomy in patients with child-pugh A and B liver cirrhosis

ABSTRACT

Laparoscopic cholecystectomy [LC] has been widely adopted in treating benign gallbladder diseases. Cirrhosis and cirrhotic portal hypertension were contraindicated for LC in its early period. In recent years, several studies have reported liberal use of LC in patients with cirrhosis. In this study, we evaluated LC in patients with Child-Pugh A and B liver cirrhosis with LC in patients without cirrhosis as regards operative time, rate and cause of conversion if occurred, morbidity, mortality and hospital stay time. During the period from January 1999 to January 2004 [5 years], at Ain shams University hospitals, 50 consecutive patients with gallstone disease and associated liver cirrhosis of Child-Pugh A and B class included 14 males and 36 females with mean age 45.6 years [range, 22-65] underwent LC [group A]. Another 50 patients with gallstone disease who were proved not to be suffering from cirrhosis included 8 males and 42 females with mean age 41.5 years old [range, 20-61] underwent LC during the same period were used as a control group [group B]. Mean operative time [min.] for group A was 74.5 and for group B 68.25, while conversion rate was 24% for A and 8% for B. Both were statistically insignificant. Total morbidity for group A was 28% and for group B 2% which is statistically significant. Bleeding was the most common complication in group A [24%], while other complications were statistically insignificant. The mean hospital stay [days] was 4.08 for group A and was 2.52 for group B which is statistically significant There was no mortality in both groups. We suggest more liberal use of laparoscopic cholecystectomy for symptomatic gallstones in selected patients with liver cirrhosis