Laparoscopic Cholecystectomy in Cirrhotic Patient

Abstract

Cholecystectomy is associated with increased risk in patients with liver cirrhosis. Moreover, cirrhosis and portal hypertension have been considered relative or absolute contraindication to laparoscopic cholecystectomy. As experience with laparoscopic cholecystectomy increased, we decided to treat cirrhotic patients via this approach. Between January 1994 and April 1995, nine patients with a Child-Pugh's stage A cirrhosis underwent elective laparoscopic cholecystectomy with intraoperative cholangiography. There was no significant per- or post-operative bleeding and no blood transfusion was necessary. There was no mortality and very low morbidity. Median hospital stay was 3 days. This series suggests that wellcompensated cirrhosis can not be considered a contraindication to laparoscopic cholecystectomy.

Laparoscopic cholecystectomy in cirrhotic patients: Feasibility in a developing country

“…[ 14 15 ] For the general population, conversion rate during LC ranges from 0 to 9%. [ 17 18 ] Our rate of conversion to open procedure (6.7%) was similar to published data for LC conversion in a noncirrhotic patient population,[ 19 20 ] reflecting the fact that cirrhotic patients are not necessarily a high-risk group for conversion.…”

Meta-analysis of laparoscopic versus open cholecystectomy for patients with liver cirrhosis and symptomatic cholecystolithiasis

“…Longer‐term complications after cholecystectomy, such as abdominal wall hernias and adhesions, occur less frequently after LC than OC in patients with a non‐cirrhotic liver34. Therefore, LC might be even more beneficial for patients with liver cirrhosis, particularly those who will require liver transplantation in the future6, 10, 16, 28, 35. However, these long‐term complications were not assessed in the four studies included in the present analysis.…”

Laparoscopic or open cholecystectomy in cirrhosis: a systematic review of outcomes and meta-analysis of randomized trials

“…Forty‐four studies were included in the analysis 7,13,15,16,22,27–65 . These included three RCTs comparing open and laparoscopic surgery in cirrhosis, 47,52,56 three case–control studies 22,29,37 and 38 case series 7,13,15,16,27,28,30–36,38–46,48–51,53–55,57–65 . Two RCTs comparing outcomes of conventional LC and LC performed using the harmonic scalpel in cirrhotic patients were included 28,57 .…”