A COMPARISON OF LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY IN PATIENTS WITH COMPENSATED CIRRHOSIS AND SYMPTOMTIC GALL STONES
Morshed, M., El-Awadi, S., Khafagi, W., Moatamed, A., Ragab, E. (2003). A COMPARISON OF LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY IN PATIENTS WITH COMPENSATED CIRRHOSIS AND SYMPTOMTIC GALL STONES. EKB Journal Management System, 22(3), 249-255. doi: 10.21608/ejsur.2003.374511
Mossad Morshed; Saleh El-Awadi; Wael Khafagi; Ahmad Moatamed; Elham Ragab. "A COMPARISON OF LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY IN PATIENTS WITH COMPENSATED CIRRHOSIS AND SYMPTOMTIC GALL STONES". EKB Journal Management System, 22, 3, 2003, 249-255. doi: 10.21608/ejsur.2003.374511
Morshed, M., El-Awadi, S., Khafagi, W., Moatamed, A., Ragab, E. (2003). 'A COMPARISON OF LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY IN PATIENTS WITH COMPENSATED CIRRHOSIS AND SYMPTOMTIC GALL STONES', EKB Journal Management System, 22(3), pp. 249-255. doi: 10.21608/ejsur.2003.374511
Morshed, M., El-Awadi, S., Khafagi, W., Moatamed, A., Ragab, E. A COMPARISON OF LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY IN PATIENTS WITH COMPENSATED CIRRHOSIS AND SYMPTOMTIC GALL STONES. EKB Journal Management System, 2003; 22(3): 249-255. doi: 10.21608/ejsur.2003.374511

A COMPARISON OF LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY IN PATIENTS WITH COMPENSATED CIRRHOSIS AND SYMPTOMTIC GALL STONES

The Egyptian Journal of Surgery
Volume 22, Issue 3, July 2003, Page 249-255  XML PDF (418.77 K)
Document Type: Original Article
DOI: 10.21608/ejsur.2003.374511
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Authors
Mossad Morshed* 1; Saleh El-Awadi1; Wael Khafagi1; Ahmad Moatamed1; Elham Ragab2
1Departments of General Surgery, Mansoura Faculty of Medicine, Mansoura, Egypt
2Clinical Pathology, Mansoura Faculty of Medicine, Mansoura, Egypt
Abstract
Background: The advantages of laparoscopic cholecystcytomy (LC) for most patients have been extensively published. 
However its benefits and successful use in patients with cirrhosis are less documented. 
Methods: A randomized prospective study,. where fifty patients with symptomatic gallstone cholecystectomy disease 
between January 1999 and December 2001 undergone either open cholecystectomy (OC) or laparoscopic. These patients were randomized into 2 groups: Group I included 24 patients who underwent OC, and Group II included 26 patients who 
underwent LC. Patients age, sex, clinical presentation and child – Turcotte – Pugh (CTP) class were documented. No patients in this study had CTP class C cirrhosis. 
Main outcome measures: operative time, postoperative pain (measured by visual analogue scale), hospital stay, blood loss, morbidity, recovery time (return to work), and liver function tests abnormalities. 
Results: there was no operative mortality. Conversion to OC was necessary in3 patients. Mean surgical time was 
significantly longer in OC group (group I) than LC group (group II). (mean ± SD, 96.6 ± 32 minuets vs 58.7 ± 23.8 minuets, P = 0.037). No patients in Group II required any blood replacement in contrast to 9 patients (37.5 %) in Group I. Intraoperative bleeding remained significantly higher in Group I. (P = 0.043). No patients in Group II had wound complications compared with 5 patients (29.14 %) in Group I. The Group I had significantly longer hospital stay than Group II (mean 9.0± 1.3 days (median 7) Vs 2.3 days ±1.9 (median 2.5); P = 0.001. 
Conclusion: Our results demonstrate that laparoscopic cholecystectomy can be performed safely in patients with CTP class A and B cirrhosis. It offers several advantage over open cholecystectomy, including lower morbidity, shorter operative time, and reduced hospital stay with less need for blood transfusions. 
Keywords
Liver Cirrhosis; Child Turcotte-pugh classification; Open cholecystectomy and laparoscopic cholecystectomy
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