PP 60. Laparoscopic Cholecystectomy in Cirrhotic Patients

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F. Lapolla, V. Neri

18:10 - 18:16h at Lanchid Room

Categories: Poster Session , Surgical Oncology

Session: Poster (P5) - Hepatobiliary & Pancreatic Surgery

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Background
Cholelithiasis is twice as prevalent in patients with cirrhosis as compared with the general population. The aim of this study was to value in a cohort of cirrhotic patients undergoing cholecystectomy, the safety of laparoscopic approach.

Material and Methods
In the period 2002-2012 we treated 65 patients with cirrhosis who underwent a cholecystectomy: 28 males, 37 females; mean age 58.4 years (range 27-83 y). we evaluated among cirrhotics the results between laparoscopic, converted to open and open approach using Student t test analysis. The choice of the approach was made on the basis of clinical evaluation of each patient. We also compared the results with a control group of non cirrhotic patients.

Result
Sixty-five procedure were performed. Subdivision according Child-Pugh score was: Class A 66.2%; Class B 29.2%; Class C 4.6%. Six patients in the cirrhotic cohort underwent OC, the remainder LC with 12 converted to OC (conversion rate 20.3%). In cirrhotic group in all were 17 (26.15%) blood or blood products transfusion; none in non cirrhotic group. Postoperative morbidity was 10.8% in cirrhotics, whereas was 2.46% in non cirrhotic group. The changes of LFTs between pre and postoperative control was not statistically significant in cirrhotics. The mean hospital stay with LC was 4.8 days vs 9.1 days in cirrhotics.

Conclusion
Cirrhotic patients with symptomatic cholelithiasis have increased hospital stay, operative time and postoperative morbidity with open cholecystectomy versus laparoscopic approach; therefore minimally invasive surgery should be the preferred initial choice.