Safety analysis of laparoscopic cholecystectomy in cirrhotic patients

Objective To analyze safety of laparoscopic cholecystectomy(LC) in cirrhotic patients with cholecystolithiasis.Methods Retrospective analysis of 497 cases information of LC for cholecystolithiasis from 2010 to 2011,including 41 patients with liver cirrhosis and 456 patients without liver cirrhosis.The operative time 、blood loss、length of hospital stay and surgical complications were compared between the two groups.Results Conversion to an open procedure was necessary in 4 patients in cirrhotic patients.The mean operative time and length of hospital stay were significantly longer in cirrhotic group(P 0.05).The mean blood loss was more than control group(P 0.05).Postoperative complications were observed in 34.15% of cirrhotic patients.Trocar site hematoma(P 0.05),wound complications(P 0.05) occurred more frequently in patients with cirrhosis(Child B and C class) than in patients without cirrhosis.Two cases of continuing hemorrhage from the gallbladder bed required re-operation for hemostasis.Two patients with Child-Pugh class C and two patients with class B cirrhosis developed ascites after surgery;one patient with Child-Pugh class B had bile leakage.No deaths occurred.Conclusion LC is an effective and safe procedure in patients with liver cirrhosis,although it has longer operative time and more postoperative complications.For patients with Child-Pugh class C,the surgery should be avoided unless clearly indicated.