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Laparoscopic Cholecystectomy Appears Safe For Some Cirrhotic Patients
A DGReview of :"Laparoscopic Cholecystectomy in Cirrhotic Patients"
Surgical Laparoscopy Endoscopy and Percutaneous Techniques
09/06/2002
By James Adams
Laparoscopic cholecystectomy appears safe for Child-Pugh class A and B patients with compensated cirrhosis.
Previous studies have reported the benefits of laparoscopic cholecystectomy, and it has become the treatment of choice for symptomatic gallstones. However, its safety and efficacy in cirrhotic patients is less well documented, according to investigators from the Department of Digestive Surgery at Angers University Hospital in Angers, France.
The investigators conducted a retrospective review of 26 consecutive laparoscopic cholecystectomies performed on cirrhotic patients from 1992 to 2000.
Twenty patients were men and six were women. Their mean age was 57 years with a range of 37 to 76 years. All of the patients had histologically confirmed cirrhosis.
Twenty-two patients had Child's class A cirrhosis and four had Child's class B cirrhosis. None had Child's class C cirrhosis.
Mean duration of operation was 126 minutes with a mean estimated blood loss of 110 milliliters. Mean length of stay in the hospital was five days.
Seven patients (27 percent) experienced complications. No operative mortality occurred.
Controlled studies are still required to confirm the safety of laparoscopic cholecystectomy for cirrhotic patients, the investigators point out. In addition, studies are needed to address the treatment of patients with Child's class C cirrhosis.
Surg Laparosc Endosc Percutan Tech 2002; 12(4): 227-231
"Laparoscopic Cholecystectomy in Cirrhotic Patients"
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