Cholelithiasis and Cirrhosis: a Comparison between Open and Laparoscopic Cholecystectomy

Abstract

Viral Hepatitis B and C related hepatitis is endemic in Pakistan, and chronic liver disease secondary to these infections is one of the major public health problems in our country, Clinical and autopsy studies have sug-gested that the prevalence of gallstones is increased in patients with cirrhosis, a finding generally attributed to accelerated pigment stone formation. This study was conducted on 50 patients in Lyari General Hospital and Civil hospital Karachi Pakistan. The patients were allocated in 2 groups 25 in each group, it was quasi – experimental, purposive and non-probability sampling of the participants. Duration of study was1 year, Pati-ents age, sex, clinical presentation and child – Tur-cotte – Pugh (CTP) class were documented. No pati-ents in this study had CTP class C cirrhosis. Main out-come measures: operative time, postoperative pain (measured by visual analogue scale), hospital stay, blood loss, morbidity, recovery time (return to work).

Results:  There was no operative mortality. Conver-sion to OC was necessary in3 patients. Mean surgical time was significantly longer in OC group (group I) than LC group (group II) 96.13 + 17.33 and 76.13 + 15.13 p = < 0.05. Intraoperative bleeding was seen Group I. Eight (32%) patients in Group II had post-operative complications compared with 15 patients (60.0%%) in Group I. The Group I had significantly longer hospital stay than Group II (6 + 1.74) (3 – 9) and 1.87 + 1.11 (1 – 5) < 0.01.

Conclusion:  Our results demonstrate that laparosco-pic cholecystectomy can be performed safely in pati-ents with cirrhosis.

Key Words:  Open cholecystectomy and laparoscopic cholecystectomy, cirrhosis.