肝硬化合并有症状胆结石患者的腹腔镜胆囊切除术
Laparoscopic cholecystectomy in patients with cirrhosis of the liver and symptomatic cholelithiasis.
作者信息
Pavlidis Theodoros E, Symeonidis Nikolaos G, Psarras Kyriakos, Skouras Christos, Kontoulis Theodoros M, Ballas Konstantinos, Rafailidis Savas F, Marakis Georgios N, Sakantamis Athanasios K
机构信息
Second Propedeutical Department of Surgery, Aristotle University of Thessaloniki, Hippocration Hospital, Greece.
出版信息
JSLS. 2009 Jul-Sep;13(3):342-5.
BACKGROUND
The indications and benefits of laparoscopic cholecystectomy (LC) in patients with liver cirrhosis and symptomatic cholelithiasis have not been satisfactorily documented. The aim of this study was to investigate its efficacy and safety in such patients.
METHODS
Medical records of 38 patients with liver cirrhosis (stages Child-Pugh A and B) who underwent LC were retrospectively reviewed. Demographic characteristics and other parameters including initial presentation, conversion rate, complication rate, mortality, and duration of hospital stay were investigated and compared with noncirrhotic patients' parameters in our database.
RESULTS
Cirrhotic patients who underwent LC were older than noncirrhotic patients (P=0.021). Both the conversion rate (15.78%) and the duration of hospital stay were increased in the cirrhotic group, but without significant differences. Major complications occurred more often in the cirrhotic group (P=0.027), increasing morbidity; however, the mortality was zero.
CONCLUSIONS
LC can be safely performed in Child-Pugh A and B cirrhotic patients with symptomatic gallstone disease, with acceptable complication and conversion rates. The increased risk for a major complication, however, demands more attention than usual.
背景
腹腔镜胆囊切除术（LC）在肝硬化合并症状性胆石症患者中的适应证和益处尚未得到充分记录。本研究的目的是调查其在此类患者中的疗效和安全性。
方法
回顾性分析38例接受LC的肝硬化患者（Child-Pugh A级和B级）的病历。调查人口统计学特征和其他参数，包括初始表现、中转率、并发症发生率、死亡率和住院时间，并与我们数据库中非肝硬化患者的参数进行比较。
结果
接受LC的肝硬化患者比非肝硬化患者年龄更大（P=0.021）。肝硬化组的中转率（15.78%）和住院时间均增加，但无显著差异。肝硬化组主要并发症发生率更高（P=0.027），发病率增加；然而，死亡率为零。
结论
对于Child-Pugh A级和B级肝硬化合并症状性胆石症的患者，LC可以安全进行，并发症和中转率均可接受。然而，主要并发症风险增加需要比平时更多的关注。
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