Laparoscopic Versus Open Cholecystectomy in Patients with Liver Cirrhosis: A Prospective, Randomized Study
| Autor: | Tahra Sherif, Mahmoud. N. Abdel-Salam, Mohammad Zein El-Deen Hafez, Abdalla Badawy, Farouk A Mourad, Mohammad El-Taher Abdel-Rahman, Mostafa Thabet, Mostafa A. Hamad |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Cirrhosis medicine.medical_treatment Open cholecystectomy law.invention Randomized controlled trial Cholelithiasis law Humans Medicine Cholecystectomy In patient Prospective Studies Prospective cohort study Aged Aged 80 and over business.industry General surgery Gallstones Middle Aged medicine.disease Surgery Cholecystectomy Laparoscopic Female Liver function business |
| Zdroj: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 20:405-409 |
| ISSN: | 1557-9034 1092-6429 |
| DOI: | 10.1089/lap.2009.0476 |
| Popis: | Gallstones are more common in patients with liver cirrhosis than in healthy individuals. Higher morbidity and mortality were reported in cirrhotic patients with either laparoscopic or open cholecystectomy. The aim of this study was to compare laparoscopic and open cholecystectomy in cirrhotic patients with symptomatic cholelithiasis in a prospective, randomized manner.Thirty patients with symptomatic cholelithiasis associated with Child-Pugh class A or B liver cirrhosis were prospectively and randomly grouped equally to either laparoscopic or open cholecystectomy. The two groups were compared regarding operative time, morbidity, mortality, postoperative liver function, and hospital stay.The two groups were comparable regarding demographic data, preoperative and postoperative Child-Pugh scoring, mean operative time (57.3 minutes for laparoscopic and 48.5 for open), and complications (33.3% for each). Hospital stay was shorter for the laparoscopic group. One conversion (6.7%) to open surgery was reported. No periopertive mortality occurred in either group.For Child-Pugh class A and B cirrhotics, laparoscopic cholecystectomy is comparable to the open approach regarding operative time, morbidity, mortality, and effect on liver function, but with shorter hospital stay. Considering the other well-documented advantages of the laparoscopic approach, namely, less pain, earlier mobilization and feeding, and better cosmoses, laparoscopic cholecystectomy would be the first choice in cirrhotic patients. |
| Databáze: | OpenAIRE |
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