Abstract | BACKGROUND: Open cholecystectomy is associated with considerable morbidity and mortality in cirrhotic patients. Laparoscopic cholecystectomy may offer a better option because of the magnification available and the availability of newer instruments like the ultrasonic shears. We present our experience of 265 laparoscopic cholecystectomies and attempt to identify the difficulties encountered in this group of patients. STUDY DESIGN: RESULTS: Features of acute cholecystitis were present in 35.1% of the patients, and 64.9% presented with chronic cholecystitis. In 81.5% of the patients, the diagnosis of cirrhosis was established preoperatively. In 8.3% of the patients, a fundus first method was adopted when the hilum could not be approached despite additional ports. Modified subtotal cholecystectomy was performed in a total of 206 patients. Mean operative time in the subtotal cholecystectomy group was 72 minutes; in the standard group, it was 41 minutes. There was no mortality. In 15% of patients, postoperative deterioration in liver function occurred. Worsening of ascites, port site infection, port site bleeding, intraoperative hemorrhage, bilious drainage, and stone formation in the remnant were the other complications encountered. CONCLUSIONS:
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Authors | Chinnasamy Palanivelu, Pidigu Seshiyer Rajan, Kalpesh Jani, Alangar Roshan Shetty, Karuppasamy Sendhilkumar, Palanisamy Senthilnathan, Ramakrishnan Parthasarthi |
Journal | Journal of the American College of Surgeons
(J Am Coll Surg)
Vol. 203
Issue 2
Pg. 145-51
(Aug 2006)
ISSN: 1072-7515 [Print] United States |
PMID | 16864026
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Cholecystectomy, Laparoscopic
(methods)
- Female
- Follow-Up Studies
- Gallstones
(complications, surgery)
- Humans
- Length of Stay
- Liver Cirrhosis
(complications)
- Male
- Middle Aged
- Patient Selection
- Retrospective Studies
- Treatment Outcome
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