A comparison of laparoscopic and open cholecystectomy In patients with liver cirrhosis

الملخص EN

Aim: gallstone is more common in patients with liver cirrhosis than in healthy individuals.

Higher morbidity and mortality were reported in cirrhotic patients with both laparoscopic and open cholecystectomy.

The aim of this study was to compare laparoscopic and open cholecystectomy in cirrhotic patients with symptomatic cholelithiasis. Methods: thirty patients with symptomatic cholelithiasis associated with Child-Pugh class A or B liver cirrhosis were prospectively randomized equally to either laparoscopic or open cholecystectomy.

The two groups were compared regarding operative time, morbidity, mortality, and postoperative liver function. Results: the two groups were comparable regarding demographic data, preoperative and postoperative Child-Pugh scoring, mean operative time (57.3 min for laparoscopic and 48.5 min for open), and complications (26.7% for laparoscopic and 33.3% for open).

One case was converted (6.7%) to open surgery.

No periopertive mortality occurred in both groups. Conclusion: For Child-Pugh class A and B cirrhotics laparoscopic cholecystectomy is comparable to open approach regarding operative time, morbidity, mortality and effect on liver function.

Considering the other well documented advantages of laparoscopic approach namely less pain, earlier mobilization and feeding, shorter hospital stay, and better cosmoses, laparoscopic cholecystectomy would be the first choice in cirrhotic patients.