Laparoscopic treatment of cholelithiasis in cirrhotic patients

Objective: to assess the safety and efficacy of laparoscopy in the treatment of symptomatic cholelithiasis in patients with Childs Class A and Class B cirrhosis. Study design: descriptive and retrospective study. Patients: we studied 14 patients (mean age 60 yrs) with Childs Class A and Class B hepatic cirrhosis who underwent la- paroscopic cholecystectomy. We analyzed the occurrence of intra- operative and postoperative complications. Results: eight patients were women (57.14%) and 6 were men (42.85%). Eight of the 14 patients presented with Childs 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 compli- cations were observed in 3 patients (21.42%), 2 presented with ascites which led to a worsening of Childs 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. Conclusions: LC (laparoscopic cholecystectomy) is a safe and effective alternative for the treatment of symptomatic cholelithia- sis in patients with well-compensated Childs Class A and Class B cirrhosis. Postoperative morbi-mortality is low, bleeding is unim- portant, and both duration of surgical procedure and hospital stay are short.