Laparoscopic cholecystectomy in patients with hepatic cirrhosis: A five-year experience

Our institution is a tertiary referral center that specializes in hepatobil iary surgery. To evaluate the safety, efficacy and conversion rate of lapar oscopic cholecystectomy in patients with hepatic cirrhosis, we conducted a retrospective analysis of all cirrhotic patients undergoing attempted lapar oscopic cholecystectomy during the period from 1991 to 1996. The diagnosis of cirrhosis was made on the basis of either a preoperative history, a live r biopsy, or the surgeon's operative description of the liver. Ail patients had early, well-compensated cirrhosis (Child's class A or B). A total of 3 0 patients underwent attempted laparoscopic cholecystectomy and five patien ts were converted to an open procedure (17%). The conversion rate for elect ive cases was 5% compared with 36% for urgent procedures. Two patients were converted because of varices and three because of unclear anatomy. No pati ents were converted because of bleeding. There were no operative deaths. Th e complication rate for elective procedures was 16%, with an average length of stay of 2.1 days, compared with 36% and 4.8 days, respectively, for urg ent cases. Laparoscopic cholecystectomy in patients with early, well-compen sated cirrhosis is safe and should be the treatment of choice for these pat ients.