Original Article
Prevention and treatment of laparoscopic cholecystectomy in patients with liver cirrhosis
Jiao Guiliang, Jiang Zhilong, Lu Jinliang, Cheng Zhirong, Xu Jianfeng, Zhou Bin, Chang Lai, Liu Kai
Published 2017-07-15
Cite as Chin J Prim Med Pharm, 2017,24(14): 2195-2198. DOI: 10.3760/cma.j.issn.1008-6706.2017.14.031
Abstract
ObjectiveTo explore the risk and treatment of laparoscopic cholecystectomy(LC) in patients with liver cirrhosis and cholelithiasis.
MethodsTo summarize the clinical data of 28 patients with liver cirrhosis and cholelithiasis. The patients were repeated right upper quadrant pain, including 4 cases of gallbladder neck stones incarcerated, gallbladder effusion. Among them, there were 20 cases of hepatitis B cirrhosis, 5 cases of schistosomiasis cirrhosis, 3 cases of alcohol.
ResultsThere were 6 patients with hemorrhage during operation. Among them, 5 patients were treated with gelatin sponge, hemostatic gauze and bio-glue spray to stop bleeding, 1 case was transferred to open surgery because of bleeding. The remaining 27 cases of LC were successful. Complications occurred in 8 patients, 3 cases of increased liver function abnormalities, 1 case of upper gastrointestinal bleeding, 1 case of mild hepatic encephalopathy, 2 cases of significant ascites formation, 1 patient underwent subtotal resection of the gallbladder with Hartmanns bag, and bile was found in the ascites after surgery, but the bile disappeared after five days. All patients with complications after symptomatic treatment were cured, no death, no major bleeding and liver failure, bile duct injury, severe biliary fistula and other serious complications.
ConclusionAlthough the risk of LC in patients with liver cirrhosis is higher than that in the general population, with the help of current high-tech surgical instruments, we can safely accomplish this with an improved surgical procedure. As these patients require high technical requirements of surgery, surgeons must have a wealth of experience and familiar laparoscopic liver and gallbladder anatomy.
Key words:
Cholecystectomy; Laparoscopic; Liver cirrhosis
Contributor Information
Jiao Guiliang
Department of General Surgery, the People's Hospital of Taixing Affiliated to Yangzhou University, Taixing, Jiangsu 225400, China
Jiang Zhilong
Lu Jinliang
Cheng Zhirong
Xu Jianfeng
Zhou Bin
Chang Lai
Liu Kai