Resumen de Colecistectomía laparoscópica y clásica en pacientes con cirrosis hepática
Jaime Poniachik, Silvia Castro A, Ana María Madrid S, Rodrigo Quera P, José Amat V, Gladys Smok, Miguel Cumsille G, Javier Brahm
Background: The prevalence of gallstones is increased in patients with cirrhosis. However the presence of cirrhosis has been generally considered a relative contraindication to cholecystectomy. Aim: To investigate the complications and the outcomes of laparoscopic and open cholecystectomy in patients with cirrhosis. Patients and Methods: Sixty seven patients with gallstones with well-documented cirrhosis undergoing cholecystectomy (laparoscopic cholecystectomy (LC) in 35 and open cholecystectomy (OC) in 32), were studied. The mean age was 57.7 + 10.3 years for LC and 58.9 + 11.6 years for OC. In the LC group, 26 were classified as Child-Pugh class A, 8 as Childs B class and 1 as Childs class C. In the OC group, 12 were classified as Childs class A, 15 as Childs B and 5 as Childs C. Results: Complications occurred in 4 of 35 (12.3%) LC patients (1 patients was Child A and 3 were B). In the OC group 14 of 32 patients had complications (4 Child A, 7 B and 3 C, 43.7% p <0.05 as compared with LC group). Three patients in the OC group died (9.4%). Mean hospital stay was 2.8 + 1.9 and 13 + 12 days in LC and OC patients, respectively (p <0.05). Conclusions: LC has a lower rate of complications than OC and is a reasonable option for Childs class A and B patients with cirrhosis and gallstones (Rev Méd Chile 2002; 130: 1343-8)
