CHOLECYSTECTOMY;

LAPAROSCOPIC VS OPEN IN PATIENTS WITH MILD LIVER CIRRHOSIS AND SYMPTOMATIC GALL STONES

Abstract

Objective: To compare the operative time, blood loss, postoperative pain and
length of hospitalization between open (OC) and laparoscopic cholecystectomy (LC) in Liver
cirrhotic patients with Child –Pugh class A & B. Study Design: Randomised Control Trial (RCT).
Setting and Duration: This study was conducted at Surgical department, Holy Family Hospital,
Rawalpindi from Jan 2010 to Dec 2011. Subjects and Methods: A total of 142 patients having
Liver cirrhosis secondary to Hepatitis A & Hepatitis B, who presented in OPD and ER with signs
and symptoms of gall stones were randomly allocated into two groups for open (OC) and
laproscopic cholecystectomy (LC). All of them were either in Child–Pugh class A or B. Data on the
above two groups( LC &OC) was collected and analyzed for operative time, blood loss and
length of hospitalization after operation. Results: The mean blood loss in LC group was
61.33+39.64 ml vs 90.84+29.88 ml in OC group, Mean operation time was 50.49+18.26 min in
LC group vs 59.22+15.66 in OC group which is statistically significant (p<.05). In LC group, the
mean hospital stay was 1.8+.97 days, while in OC group is 2.4+.91 days which is also
statistically significant. Conclusions: LC (laparoscopic cholecystectomy) is a safe and effective
approach for the treatment of symptomatic cholelithiasis in patients with mild cirrhosis with less
blood loss, less postoperative pain, shorter operative time and decreased hospital stay.