A COMPARISON OF OPEN AND LAPAROSCOPIC CHOLECYSTECTOMY FOR PATIENTS WITH CIRRHOSIS

To evaluate the benefits of performing laparoscopic cholecystectomy (L C) in patients with cirrhosis, data on 13 patients with liver cirrhosi s who underwent cholecystectomy for gallstones between 1989 and 1995 w ere retrospectively collected from charts filed at Fukuoka City Hospit al, These 13 patients were classified into two groups; one, comprised of 7 who underwent LC, and another, comprised of B who underwent open cholecystectomy (OC), No statistical differences were observed in the duration of surgery or the intraoperative blood loss between the two g roups; however, the C-reactive protein (CRP) level in the serum was si gnificantly higher in the OC group than in the LC group, LC was follow ed by a significantly earlier resumption of a normal diet (P < 0.05) a nd a shorter hospital stay (P < 0.05) in comparison to OC, All of the patients who underwent OC had an uneventful clinical course; however, one of the patients who underwent LC suffered from intractable ascites postoperatively. The difference in the cost of hospitalization betwee n the tno groups was not statistically significant, These findings sug gest that the therapeutic significance of performing LC in patients wi th cirrhosis should be assessed after carefully evaluating all factors including mortality, morbidity, and cost-effectiveness. Thus, further controlled trials are necessary.