A Comparison of Open and Laparoscopic Cholecystectomy for Patients with Liver Cirrhosis.
- Author:
Ki Hun KIM
1
;
Chung Ho PARK
;
Sung Gyu LEE
;
Young Joo LEE
;
Kwang Min PARK
;
Shin HWANG
;
Dong Lak CHOI
;
Jae Han JEONG
;
Chul Soo AHN
;
Pyung Chul MIN
Author Information
1. Department of Surgery, Ulsan University College of Medicine, Asan Medical Center.
- Publication Type:Original Article
- Keywords:
Liver cirrhosis;
Open cholecystectomy;
Laparoscopic cholecystectomy
- MeSH:
Ascites;
Biliary Tract;
Cholecystectomy;
Cholecystectomy, Laparoscopic*;
Cholelithiasis;
Chungcheongnam-do;
Fibrosis;
Hemorrhage;
Humans;
Incidence;
Liver Cirrhosis*;
Liver*;
Mortality;
Postoperative Complications;
Retrospective Studies
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2000;4(2):147-152
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUNDS/AIMS: Cholelithiasis is a prevalent diseases worldwide and it is known that its incidence is twice as common in cirrhotic patients compared with noncirrhotic patients. Liver cirrhosis is a critical factor contributing to morbidity and mortality in biliary tract surgery, as patient with cirrhosis are at particular risk of developing bleeding, infection and intractable ascites. Recently laparoscopic cholecystectomy has become the procedure of choice for cholelithiasis in the general population. This retrospective study was conducted to assess the effective treatment by comparing the results of open cholecystectomy versus laparoscopic cholecytectomy in cirrhotic patients. METHODS: Between January 1991 and December 1998, 53 patients with liver cirrhosis underwent cholecystectomy for cholelithiasis in the department of surgery at asan medical center. The patients were classified into two groups: one consisting of 18 patients who underwent open cholecystectomy and another consisting of 35 patients who underwent laparoscopic cholecystectomy. All cases that converse to an open cholecystectomy from a laparoscopic cholecystectomy were excluded from this analysis. RESULTS: No statistical difference was observed in the duration of surgery(OC: 110.6+/-32.6 vs. LC: 82.1 +/-26.7 min, p>0.05). Laparoscopic cholecystectomy was followed by a significantly smaller intraoperative blood loss(OC: 730.5+/-384.6 vs. LC: 324+/-168 ml, p<0.05), a earlier resumption of a normal diet(OC: 4.3+/-1.3 vs. LC: 1.3+/-0.4 days, p<0.05), and a shorter hospital stay(OC: 13.8+/-6.1 vs. LC: 4.7 +/-2.1 days, p<0.05) in comparison to open cholecystectomy. Postoperative complications in laparoscopic cholecystectomy group was significantly less(OC: 9 vs. LC: 4, p<0.05). There was no operative mortality in both group. CONCLUSIONS: Laparoscopic cholecystectomy can be safely performed in compensated cirrhotic patients and may be the procedure of choice whenever cholecystectomy is indicated in a cirrhotic patient because it may be associated with more advantages.
