Cholecystectomy in cirrhotic patients: A formidable operation

Aranha, Gerard V.; Sontag, Stephen J.; Greenlee, H.

doi:10.1016/0002-9610(82)90129-5

Cited by 232 publications

(129 citation statements)

References 14 publications

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“…Early cohort studies of open cholecystectomy in patients with cirrhosis showed that surgery was associated with excessive morbidity and mortality secondary to intraoperative hemorrhage, liver failure, and/or sepsis. [5][6][7][8] As a result, the presence of moderate to severe cirrhosis has been generally considered a relative contraindication to open cholecystectomy. 9 Only limited information has been added to this subject since the introduction of less invasive laparoscopic techniques.…”

mentioning

confidence: 99%

Laparoscopic cholecystectomy and cirrhosis: A case-control study of outcomes

et al. 2000

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The incidence of gallstone disease in patients with cirrhosis is greater than that in healthy patients. Previous surgical literature reported greater morbidity and mortality in patients with cirrhosis with both open and laparoscopic cholecystectomy (LC). We compared our recent experience with LC in patients with cirrhosis and controls. A retrospective review was performed using the search terms, ''cirrhosis'' and ''laparoscopic cholecystectomy.'' Forty-eight patients with cirrhosis were identified and randomly matched with healthy controls by age and sex.

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confidence: 99%

Laparoscopic cholecystectomy and cirrhosis: A case-control study of outcomes

et al. 2000

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“…Once the diagnosis has been made, the indication for surgery is still controversial because of the high morbidity and mortality rate [7][8][9] . Hepatic function impairment causes coagulation disorders, hypoproteinemia, metabolic disturbances, portal hypertension, and ascites, which in turn reflect in a mild to severe bleeding tendency, prolonged wound healing, esophageal varices, dilatation of anterior abdominal wall veins, etc.…”

Section: Discussionmentioning

confidence: 99%

“…Yerdel et al have recently reported on expanding indications for laparoscopic cholecystectomy 13 . According to some authors, even the important factors determining the grade of liver impairment, such as prolonged prothrombin time or presence of ascites, are dubious 7,11 . Meticulous dissection of the gallbladder can be done owing to the magnification properties of videoendoscopy, thus ensuring good hemostasis of the liver bed.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Cholecystectomy in Cirrhotic Patients

2014

J de Chirurgie

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SUMMARY In the beginning, liver cirrhosis was considered a contraindication for laparoscopic cholecystectomy, mostly for the same reasons as for other surgical procedures, i.e. mild to severe bleeding tendency, prolonged wound healing due to hypoproteinemia, and various metabolic disorders. The effect of CO 2 pneumoperitoneum on the cirrhotic liver was also discussed. Results obtained by laparoscopic cholecystectomy in 24 liver cirrhosis patients are presented. The experience acquired since the introduction of laparoscopic procedures at our unit is briefly described. The index of conversion was 4.16% (1/24) and mortality rate 0. The mean length of hospital stay was 2.9 days. The use of laparoscopic cholecystectomy for gallstone disease is proposed in patients with liver cirrhosis as the first choice operative method of treatment.

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“…Unlike the normal liver, which, within [3][4][5][6][7][8][9][10][11][12] months can regenerate to its original size and function, even after 80% resection, the cirrhotic liver has impaired regenerative ability. Indeed, until recently, the cirrhotic liver was thought to be unable to regenerate [7].…”

Section: Impaired Regenerationmentioning

confidence: 99%

“…The result is an abnormal PT/PTT. Due to the short half life of clotting factors (most under 1 day), PT is a sensitive indicator of acute changes in liver synthetic function [11].…”

Section: Bleedingmentioning

confidence: 99%

Review: Research Toward Safer Resectionof the Cirrhotic Liver

Moser

Kneteman

2000

HPB Surgery

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Despite recent advances in hepatic surgery, resection of the cirrhotic liver continues to be fraught with high morbidity and mortality rates. As a result, for many patients requiring resection of HCC the postoperative course is complicated and the probability of cure is diminished by coexisting cirrhosis. In this review, we discuss the characteristics of the cirrhotic liver which make it poorly tolerant of resection and the most common complications that follow such surgery. The main purpose of this paper is to review recent attempts to identify interventions that might be beneficial to cirrhotic patients undergoing resection. These interventions include assessment of liver reserve, advances in surgical technique, and improvement in liver function and regeneration.

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Cholecystectomy in cirrhotic patients: A formidable operation

Cited by 232 publications

References 14 publications

Laparoscopic cholecystectomy and cirrhosis: A case-control study of outcomes

Laparoscopic cholecystectomy and cirrhosis: A case-control study of outcomes

Laparoscopic Cholecystectomy in Cirrhotic Patients

Review: Research Toward Safer Resectionof the Cirrhotic Liver

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