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Year : 2019  |  Volume : 4  |  Issue : 1  |  Page : 9-13

Safety and feasibility of elective laparoscopic cholecystectomy in liver cirrhosis with portal hypertension

1 Department of Surgery, District Hospital Budgam, Kashmir Health Services, Srinagar, Jammu and Kashmir, India
2 Department of Surgery, District Hospital Budgam, Kashmir Health Services; Department of Surgery, Government Medical College and Associated Hospitals, Srinagar, Jammu and Kashmir, India

Correspondence Address:
Dr. Arshad Rashid
G 22, Green Lane, Shah Anwar Colony, Hyderpora, Srinagar - 190 014, Jammu and Kashmir
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/SJL.SJL_10_19

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Aims: The aim of the present study was to evaluate the safety of laparoscopic cholecystectomy in patients with liver cirrhosis and portal hypertension. Methods: Ours was a prospective study conducted in three peripheral hospitals over a period of six years. All the patients undergoing elective laparoscopic cholecystectomy during this period were enrolled in the study. The diagnosis of cirrhosis was made based on preoperative workup, intraoperative findings, and histo-pathological study based on liver biopsy. The outcomes of laparoscopic cholecystectomy in patients with cirrhosis were compared to those without it with regards to perioperative morbidity and mortality. Results: A total of 3127 laparoscopic cholecystectomies were performed. Out of them 42 patients were diagnosed to have features of cirrhosis and portal hypertension after laparoscopy and subsequently 36 were confirmed to have cirrhosis on histopathology. There were 15 males and 21 females in these 36 patients. The diagnosis of cirrhosis was established preoperatively in 21 patients. The operative time and hospital stay were significantly increased in the cirrhotic group. None of our patients in the cirrhotic group required conversion. Perioperative complications were seen more often in the patients with cirrhosis [5 (13.89%) versus 207 (6.69%); P value = 0.0126]. Ascites was the most frequent post-operative complication seen in cirrhotic patients. Conclusion: Laparoscopic cholecystectomy, though technically demanding in cirrhotic patients can be safely done even in a peripheral health set-up with acceptable morbidity rate.

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