| Title | Cholecystectomy in cirrhotic patients: pitfalls and reasonable recommendations. | | Author(s) | Lucidi V, Buggenhout A, Donckier V | | Institution | Department of Abdominal Surgery, Hôpital Erasme, Université Libre de Bruxelles (ULB). | | Source | Acta Chir Belg 2009 Jul-Aug; 109(4):477-80. | | Abstract | Cholecystectomy in cirrhotic patients remains a high risk procedure. The recent literature was reviewed in the objective to elaborate (evidence-based) recommendations for therapeutic decision. In patients with Child Pugh A or B cirrhosis, the laparoscopic approach should be preferred as it is associated with reduced morbidity and mortality as compared with open surgery (level B). In patients with decompensated Child Pugh C cirrhosis, the scarcity of literature data renders much more hazardous the definition of robust recommendations. In these patients, two options have to be considered beyond early laparoscopic cholecystectomy: first, a delayed surgery, in order to improve the preoperative patient's general condition and namely the coagulation, and second, a percutaneous drainage in very severe cases (level C). | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19803258 |
|
