Cholecystectomy in patients with mild cirrhosis. A more favorable situation
K. Kogut, T. Aragoni and N. B. Ackerman
A conservative approach toward elective cholecystectomy in the patient with
cirrhosis has been suggested because of the strong likelihood of excessive
bleeding, sepsis, and multiple organ failure. We reviewed this problem in
two medical centers, studying 27 patients with cirrhosis who had undergone
nonemergency biliary tract surgery. Most patients had adequate liver
function preoperatively. Most operations were cholecystectomies without
duct exploration. Among factors analyzed were liver function tests,
coagulation tests, and Child's classification. Prothrombin time was less
than 2.5 s above control in 18 patients, more than 2.5 s above control in
four patients, and not recorded in five patients. All survived the
operation with benign postoperative courses. Only one patient had excessive
bleeding; this patient had an elevated prothrombin time preoperatively. We
conclude that elective cholecystectomy can be performed safely in patients
with cirrhosis who have relatively normal liver function.
