Revista chilena de cirugía
versión On-line ISSN 0718-4026
BUTTE B, JEAN MICHEL et al. Complications after cholecystectomy among cirrhotic patients. Rev Chil Cir [online]. 2007, vol.59, n.4, pp. 272-276. ISSN 0718-4026. doi: 10.4067/S0718-40262007000400005.
Background: Cirrhotic patients have a higher prevalence of cholelithiasis and a higher rate of surgical complications than the general population. Aim: To assess predictors of surgical complications among cirrhotic patients subjected to cholecystectomy. Material and methods: Review of medical records of cirrhotic patients subjected to a cholecystectomy between 2000 and 2006. Clinical, biochemical and surgical parameters were evaluated. Child and Model of End Stage Liver Disease (MELD) scores were assessed as predictors. Complications during hospital stay and in the 30 days after surgery, were recorded. Results: The clinical records of 23 patients (aged 61 ± 2 years, 11 males) were reviewed. The indications for cholecystectomy were symptomatic cholelithiasis in 20 and acute cholecystitis in three. The surgical procedure was laparoscopic in 21. Six patients had portal hypertension. Eighteen were Child A, three were Child D and one was Child C. Meld score was 8.5 ± 4.2. Two patients (Child B and C) had a hepatorenal syndrome and died, one had a surgical wound infection, one had a relapse of a lower urinary obstruction and one had seizures. These complications were observed in two Child A patients, two Child B and one Child C. Two patients with and three without portal hypertension had complications. MELD scores were 7.8 ± 3.7 and 14 ± 7 among patients with and without complications, respectively. The two patients that died had a mean MELD score of 14 ± 7, compared with the rest that had a score of 7.9 ± 3.7. Conclusions: Cirrhotic patients have a high rate of complications after cholecystectomy. Child classification, MELD score and the presence of portal hypertension may help in the prediction of mortality
Palabras clave : Cirrhosis; cholecystectomy; portal hypertension.