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 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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