LAPAROSCOPIC VERSUS OPEN CHOLECYSTECTOMY IN CIRRHOTIC-PATIENTS - A PROSPECTIVE-STUDY

The results of open cholecystectomy ([OC] n = 7) versus laparoscopic c holecystectomy ([LC] n = 7) in cirrhotic patients were analyzed prospe ctively. Groups were well matched for surgical indication, presence of ascites/bleeding tendency, and Child's grade. There was no mortality, mean operating time was significantly longer in the LC group (155 +/- 47 vs. 103 +/- 25 min, p < 0.05). Operative blood loss was significan tly greater in the OC group (128 +/- 125 vs. 642 +/- 467 ml, p < 0.05) . No patient in LC group required blood transfusion in contrast to thr ee patients in OC group. Compared with O% postoperative complications in LC group, wound infections developed in 43% of the patients in OC g roup (p < 0.0). Mean hospital stay in LC group was significantly less (6.7 +/- 4 vs. 17.4 +/- 7.3 days, p < 0.01). Thus, contrary to previou s belief, cirrhosis per se is nota contraindication to LC. Laparoscopi c cholecystectomy may be the procedure of choice whenever cholecystect omy is indicated in a cirrhotic patient because it may be associated w ith less bleeding and fewer incision-related complications.