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Cholecystectomy in Cirrhosis

  • Marcos V. Perini
  • Michael A. Fink
Chapter

Abstract

The prevalence of gallstone disease in cirrhotic patients is higher than in the general population, with almost one third having cholelithiasis [1]. The higher incidence is related to a higher incidence of pigment stones (Chap. 1). The majority (80%) are asymptomatic, with the remainder presenting with biliary pain, cholecystitis or obstructive jaundice [2].

References

  1. 1.
    Sheen IS, Liaw YF. The prevalence and incidence of cholecystolithiasis in patients with chronic liver diseases: a prospective study. Hepatology. 1989;9:538–40.CrossRefPubMedGoogle Scholar
  2. 2.
    Castaing D, Houssin D, Lemoine J, Bismuth H. Surgical management of gallstones in cirrhotic patients. Am J Surg. 1983;146:310–3.CrossRefPubMedGoogle Scholar
  3. 3.
    Del Olmo JA, Flor-Lorente B, Flor-Civera B, Rodriguez F, Serra MA, Escudero A, Lledo S, Rodrigo JM. Risk factors for nonhepatic surgery in patients with cirrhosis. World J Surg. 2003;27:647–52.CrossRefPubMedGoogle Scholar
  4. 4.
    Ziser A, Plevak DJ, Wiesner RH, Rakela J, Offord KP, Brown DL. Morbidity and mortality in cirrhotic patients undergoing anesthesia and surgery. Anesthesiology. 1999;90:42–53.CrossRefPubMedGoogle Scholar
  5. 5.
    El-Awadi S, El-Nakeeb A, Youssef T, Fikry A, Abd El-Hamed TM, Ghazy H, Foda E, Farid M. Laparoscopic versus open cholecystectomy in cirrhotic patients: a prospective randomized study. Int J Surg. 2009;7:66–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Hamad MA, Thabet M, Badawy A, Mourad F, Abdel-Salam M, Abdel-Rahman M-T, Hafez MZ, Sherif T. Laparoscopic versus open cholecystectomy in patients with liver cirrhosis: a prospective, randomized study. J Laparoendosc Adv Surg Tech A. 2010;20:405–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Ji W, Li LT, Wang ZM, Quan ZF, Chen XR, Li JS. A randomized controlled trial of laparoscopic versus open cholecystectomy in patients with cirrhotic portal hypertension. World J Gastroenterol. 2005;11:2513–7.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Lausten SB, Ibrahim TM, El-Sefi T, Jensen LS, Gesser B, Larsen CG, Tonnesen E, Jensen SL. Systemic and cell-mediated immune response after laparoscopic and open cholecystectomy in patients with chronic liver disease. A randomized, prospective study. Dig Surg. 1999;16:471–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Angrisani L, Lorenzo M, Corcione F, Vincenti R. Gallstones in cirrhotics revisited by a laparoscopic view. J Laparoendosc Adv Surg Tech A. 1997;7:213–20.CrossRefPubMedGoogle Scholar
  10. 10.
    Bessa SS, Abdel-Razek AH, Sharaan MA, Bassiouni AE, El-Khishen MA, El-Kayal El SA. Laparoscopic cholecystectomy in cirrhotics: a prospective randomized study comparing the conventional diathermy and the harmonic scalpel for gallbladder dissection. J Laparoendosc Adv Surg Tech A. 2011;21:1–5.CrossRefPubMedGoogle Scholar
  11. 11.
    Clark JR, Wills VL, Hunt DR. Cirrhosis and laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2001;11:165–9.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Curro G, Baccarani U, Adani G, Cucinotta E. Laparoscopic cholecystectomy in patients with mild cirrhosis and symptomatic cholelithiasis. Transplant Proc. 2007;39:1471–3.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Delis S, Bakoyiannis A, Madariaga J, Bramis J, Tassopoulos N, Dervenis C. Laparoscopic cholecystectomy in cirrhotic patients: the value of MELD score and Child-Pugh classification in predicting outcome. Surg Endosc. 2010;24:407–12.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Fernandes NF, Schwesinger WH, Hilsenbeck SG, Gross GW, Bay MK, Sirinek KR, Schenker S. Laparoscopic cholecystectomy and cirrhosis: a case-control study of outcomes. Liver Transpl. 2000;6:340–4.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Leandros E, Albanopoulos K, Tsigris C, Archontovasilis F, Panoussopoulos SG, Skalistira M, Bramis C, Konstandoulakis MM, Giannopoulos A. Laparoscopic cholecystectomy in cirrhotic patients with symptomatic gallstone disease. ANZ J Surg. 2008;78:363–5.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Mancero JM, D'Albuquerque LA, Gonzalez AM, Larrea FI, de Oliveira e Silva A. Laparoscopic cholecystectomy in cirrhotic patients with symptomatic cholelithiasis: a case-control study. World J Surg. 2008;32:267–70.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Morino M, Cavuoti G, Miglietta C, Giraudo G, Simone P. Laparoscopic cholecystectomy in cirrhosis: contraindication or privileged indication? Surg Laparosc Endosc Percutan Tech. 2000;10:360–3.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Palanivelu C, Rajan PS, Jani K, Shetty AR, Sendhilkumar K, Senthilnathan P, Parthasarthi R. Laparoscopic cholecystectomy in cirrhotic patients: the role of subtotal cholecystectomy and its variants. J Am Coll Surg. 2006;203:145–51.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Pavlidis TE, Symeonidis NG, Psarras K, Skouras C, Kontoulis TM, Ballas K, Rafailidis SF, Marakis GN, Sakantamis AK. Laparoscopic cholecystectomy in patients with cirrhosis of the liver and symptomatic cholelithiasis. JSLS. 2009;13:342–5.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Puggioni A, Wong LL. A metaanalysis of laparoscopic cholecystectomy in patients with cirrhosis. J Am Coll Surg. 2003;197:921–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Quillin RC III, Burns JM, Pineda JA, Hanseman D, Rudich SM, Edwards MJ, Tevar AD. Laparoscopic cholecystectomy in the cirrhotic patient: predictors of outcome. Surgery. 2013;153:634–40.CrossRefPubMedGoogle Scholar
  22. 22.
    Yeh CN, Chen MF, Jan YY. Laparoscopic cholecystectomy in 226 cirrhotic patients. Experience of a single center in Taiwan. Surg Endosc. 2002;16:1583–7.CrossRefPubMedGoogle Scholar
  23. 23.
    Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973;60:646–9.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Kim WR, Therneau TM, Benson JT, Kremers WK, Rosen CB, Gores GJ, Dickson ER. Deaths on the liver transplant waiting list: an analysis of competing risks. Hepatology. 2006;43:345–51.CrossRefPubMedGoogle Scholar
  25. 25.
    Child CG. Surgery and portal hypertension. The liver and portal hypertension. 1st ed. Philadelphia: WB Saunders; 1964.Google Scholar
  26. 26.
    Friedman LS. The risk of surgery in patients with liver disease. Hepatology. 1999;29:1617–23.CrossRefPubMedGoogle Scholar
  27. 27.
    Garrison RN, Cryer HM, Howard DA, Polk HC Jr. Clarification of risk factors for abdominal operations in patients with hepatic cirrhosis. Ann Surg. 1984;199:648–55.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Mansour A, Watson W, Shayani V, Pickleman J. Abdominal operations in patients with cirrhosis: still a major surgical challenge. Surgery. 1997;122:730–5. discussion 735-6CrossRefPubMedGoogle Scholar
  29. 29.
    Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, D'amico G, Dickson ER, Kim WR. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33:464–70.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000;31:864–71.CrossRefPubMedGoogle Scholar
  31. 31.
    Northup PG, Wanamaker RC, Lee VD, Adams RB, Berg CL. Model for end-stage liver disease (MELD) predicts nontransplant surgical mortality in patients with cirrhosis. Ann Surg. 2005;242:244–51.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    De Goede B, Klitsie PJ, Hagen SM, Van Kempen BJ, Spronk S, Metselaar HJ, Lange JF, Kazemier G. Meta-analysis of laparoscopic versus open cholecystectomy for patients with liver cirrhosis and symptomatic cholecystolithiasis. Br J Surg. 2013;100:209–16.CrossRefPubMedGoogle Scholar
  33. 33.
    Jayadevan R, Garg M, Schiano T, Divino CM. Is cholecystostomy a safe procedure in patients with cirrhosis? Am Surg. 2014;80:1169–71.PubMedGoogle Scholar
  34. 34.
    Yao Z, Hu K, Huang P, Huang H, Chen X, Yang P, Liu B. Delayed laparoscopic cholecystectomy is safe and effective for acute severe calculous cholecystitis in patients with advanced cirrhosis: a single center experience. Gastroenterol Res Pract. 2014;2014:178908.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Teh SH, Nagorney DM, Stevens SR, Offord KP, Therneau TM, Plevak DJ, Talwalkar JA, Kim WR, Kamath PS. Risk factors for mortality after surgery in patients with cirrhosis. Gastroenterology. 2007;132:1261–9.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Azoulay D, Buabse F, Damiano I, Smail A, Ichai P, Dannaoui M, Castaing D, Bismuth H. Neoadjuvant transjugular intrahepatic portosystemic shunt: a solution for extrahepatic abdominal operation in cirrhotic patients with severe portal hypertension. J Am Coll Surg. 2001;193:46–51.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Kim JJ, Dasika NL, Yu E, Fontana RJ. Cirrhotic patients with a transjugular intrahepatic portosystemic shunt undergoing major extrahepatic surgery. J Clin Gastroenterol. 2009;43:574–9.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Cao AM, Eslick GD, Cox MR. Early cholecystectomy is superior to delayed cholecystectomy for acute cholecystitis: a meta-analysis. J Gastro Intest Surg. 2015;19:848–57.CrossRefGoogle Scholar
  39. 39.
    Cao AM, Eslick GD, Cox MR. Early laparoscopic cholecystectomy is superior to delayed in acute cholecystitis: a meta-analysis of case controlled studies. Surg Endosc. 2016;30(3):1172–82.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Elshaer M, Gravante G, Thomas K, Sorge R, Al-Hamali S, Ebdewi H. Subtotal cholecystectomy for “difficult gallbladders”: systematic review and meta-analysis. JAMA Surg. 2015;150:159–68.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Strasberg S, Gouma DJ. Extreame vasculobiliary injuries: assocation with fundus down cholecystectomy in inflammed gallbladdrs. HPB Surg. 2012;14:1–8.CrossRefGoogle Scholar
  42. 42.
    Hamada T, Yasunaga H, Nakai Y, Isayama H, Horiguchi H, Fushimi K, Koike K. Severe bleeding after percutaneous transhepatic drainage of the biliary system: effect of antithrombotic agents - Analysis of 34606 cases from a Japanese nationwide administrative database. Radiology. 2015;274:605–13.CrossRefPubMedGoogle Scholar
  43. 43.
    Tujios SR, Rahnama-Moghadam S, Elmunzer JB, Kwon R, Singal AG, Anderson MA, Wamsteker E-J, Taylor JR, Scheiman J, Elta G, Fontana RJ, Piraka CR. Transpapillary gallbladder stents can stabilize or improve decompensated cirrhosis in patients awaiting liver transplantation. J Clin Gastroenterol. 2015;49:771–7.CrossRefPubMedGoogle Scholar
  44. 44.
    Douard R, Lentschener C, Ozier Y, Dousset B. Operative risks of digestive surgery in cirrhotic patients. Gastroenterol Clin Biol. 2009;33:555–64.CrossRefPubMedGoogle Scholar
  45. 45.
    Artifon EL, Da Silveira EB, Aparicio D, Takada J, Baracat R, Sakai CM, Garcia RT, Teich V, Couto DS. Management of common bile duct stones in cirrhotic patients with coagulopathy: a comparison of supra-papillary puncture and standard cannulation technique. Dig Dis Sci. 2011;56:1904–11.CrossRefPubMedGoogle Scholar
  46. 46.
    Chijiiwa K, Kozaki N, Naito T, Kameoka N, Tanaka M. Treatment of choice for choledocholithiasis in patients with acute obstructive suppurative cholangitis and liver cirrhosis. Am J Surg. 1995;170:356–60.CrossRefPubMedGoogle Scholar
  47. 47.
    Sugiyama M, Atomi Y, Kuroda A, Muto T. Treatment of choledocholithiasis in patients with liver cirrhosis. Surgical treatment or endoscopic sphincterotomy? Ann Surg. 1993;218:68–73.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Park DH, Kim MH, Lee SK, Lee SS, Choi JS, Song MH, Seo DW, Min YI. Endoscopic sphincterotomy vs. endoscopic papillary balloon dilation for choledocholithiasis in patients with liver cirrhosis and coagulopathy. Gastrointest Endosc. 2004;60:180–5.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Surgery, Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneMelbourneAustralia

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