Acute cholecystitis in patients with liver cirrhosis: peculiarities of diagnosis and minimally invasive treatment

Abstract

Surgical treatment of acute cholecystitis (aC) in patients with liver cirrhosis is accompanied by large number of complications. Within last 15 years, 94 patients with aC conditioned by liver cirrhosis underwent treatment in the department: 76 patients underwent laparoscopic cholecystectomy (LCE), 5 (6.2 %) – conversion to open operation. 22 patients with obstrutive jaundice firstly underwent endoscopic transpapillary procedures and in 0.1–5 days – LCE. Postoperative complications developed in 22 (27.2 %) cases: 3 (3.7 %) patients had intraab- dominal hemorrhage, 9 (11.1 %) – ascitic fluid leakage through drainage and ports, 3 (3.7 %) – oesophageal varices bleeding, 7 (8.6 %) – cardiac pulmonal and others complications. 2 (2.5 %) patients died due to the progression of hepatocellular failure, caused by bleeding from oesophageal varices after the operation. The number of intra- and postopera- tive complications can be reduced by precise ultrasound with colour doppler of hepatoduodenal region and abdominal wall, as well as by the fulfilment of the recommendations of Baveno Consensus.