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Clinical Question:
In patient with cirrhosis, is Laparoscopy effective and safe in the
treatment of cholelithiasis?
Bottom Line:
LC (laparoscopic cholecystectomy) is a safe and effective alternative for
the treatment of symptomatic cholelithiasis in patients with
well-compensated Child s Class A and Class B cirrhosis. Postoperative morbi-mortality
is low, bleeding is unimportant, and both duration of surgical procedure and
hospital stay are short
Reference:
Laparoscopic treatment of cholelithiasis in cirrhotic patients.Flores Cortes
M, Obispo Entrenas A, Docobo Durantez F, Romero Vargas E, Legupin Tubio D,
Valera Garcia Z.
Study Design:
Descriptive and retrospective study
Synopsis:
The author assessed the safety and efficacy of laparoscopy in the treatment
of symptomatic cholelithiasis in patients with Child s Class A and Class B
cirrhosis.Descriptive and retrospective study was done.Patients to 14
patients (mean age 60 yrs) with Child s Class A and Class B hepatic
cirrhosis who underwent laparoscopic cholecystectomy. We analyzed the
occurrence of intraoperative and postoperative complications.Eight patients
were women (57.14%) and 6 were men (42.85%). Eight of the 14 patients
presented with Child s Class B cirrhosis and 6 patients with Class A.
Cholecystectomy was programmed for all patients. The average duration of
surgery was 77 min. Intraoperative complications occurred in 2 patients
(14.28%) in the form of liver bed bleeding. Postoperative complications were
observed in 3 patients (21.42%), 2 presented with ascites which led to a
worsening of Child s Class in one of them, and the third patient presented
with angina-like symptoms (acute, sharp pain in the chest irradiating to the
back). Mean length of hospital stay was 3 days. No postoperative morbidity
or mortality occurred, and there were no conversions. |