Laparoscopic Cholecystectomy in patients with Chronic Liver Disease; A ten years experience
To evaluate the safety and efficacy of laparoscopic cholecystectomy in patients with chronic liver disease. It was a retrospective analysis. The study was conducted at Shaikh Zayed Hospital, Lahore between 1993 and 2002. Out of 656 patients undergoing laparoscopic cholecystectomy during this period, 22(6 male, 16 female) were having chronic liver disease as well. Ultrasonography was mainstay of diagnosis of cholelithiasis while liver function tests, platelet count and prothrombin time were done to evaluate liver status.. Eighteen patients were having Child`s class A while rest were in Child`s class B. Laparoscopic cholecystectomy was successful in 20 patients of chronic liver disease. Liver biopsy and paraumbilical hernia repair were additional procedures performed in 8 patients. Two patients were converted to open cholecystectomy due to bleeding and adhesions. Acute cholecystitis was found in 3 patients while rest were having chronic cholecystitis. Mean operative time was 75.45+/-10.9 minutes and mean hospital stay was 2.81+/-1.1 days. Postoperative complications in the form of wound infection (2 pts), prolonged ileus (2 pts) and port hernia (1 pt) occurred in 5 patients. There was no mortality. Laparoscopic cholecystectomy can be safely performed in patients with mild to moderate chronic liver disease without any additional morbidity.
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