A comparison of an open and laparoscopic appendectomy for patients with liver cirrhosis

Liver cirrhosis is a critical factor contributing to morbidity and mortalit y in abdominal surgery, because patients with cirrhosis have a particularly high risk of developing bleeding, infection, and ascites. Laparoscopic app endectomy (LA) recently has gained a lot of attention around the world; how ever, comparisons between the benefits of LA and those of conventional open appendectomy (OA) for patients with liver cirrhosis have yet to be suffici ently compiled. In the present retrospective study, 40 patients with liver cirrhosis who were diagnosed with acute appendicitis before surgery underwe nt an appendectomy (OA in 25 patients and LA in 15 patients). This study fo cused on the operative time, amount of postoperative pain, use of analgesic s, the restart of a normal diet, number of complications, length of hospita l stay, and cost-effectiveness of the procedure in such patients. The amoun t of postoperative pain and the length of hospital stay were significantly smaller in the LA group. The mean values of the serum C-reactive protein on postoperative days 1, 3, and 7 were significantly less in the LA group. Th e number of wound infections and wound bleeding was also less in the LA gro up. The difference in the total cost of hospitalization was not significant . The cost of the operation was greater in the LA group than in the OA grou p, whereas the hospitalization cost in the LA group was less than that in t he OA group. The results of this study suggest that LA may be superior to O A for the treatment of postoperative pain and postoperative complications f or patients with liver cirrhosis. Long-term follow-up studies are still nec essary, however, to determine any possible decrease in the number of late c omplications.