Abstract
Acute calculous cholecystitis is a common disease in cirrhotic patients. Laparoscopic cholecystectomy can resolve this problem but is performed based on the premise that the local inflammation must been controlled. An Initial ultrasound guided percutaneous transhepatic cholecystostomy may reduce the local inflammation and provide advantages in subsequent surgery. In this paper, we detailed our experience of treating acute severe calculous cholecystitis in patients with advanced cirrhosis by delayed laparoscopic cholecystectomy plus initiated ultrasound guided percutaneous transhepatic cholecystostomy and provided the analysis of the treatment effect. We hope this paper can provided a kind of standard procedure for this special disease; however, further prospective comparative randomized trials are needed to assess this treatment in cirrhotic patients with acute cholecystitis.
Highlights
Cholelithiasis is a common disease in cirrhotic patients
An incarcerated gallbladder stone in the gallbladder neck may result in acute cholecystitis (AC), a finding that is commonly observed in cirrhotic patients, with subsequent distension and severe bacterial inflammation of the gallbladder [3]
We aimed to evaluate the outcomes of patients with liver cirrhosis who underwent delayed laparoscopic cholecystectomy (LC) for incarcerated gallbladder disease at our institution during the last 7 years
Summary
Cholelithiasis is a common disease in cirrhotic patients. An incarcerated gallbladder stone in the gallbladder neck may result in acute cholecystitis (AC), a finding that is commonly observed in cirrhotic patients, with subsequent distension and severe bacterial inflammation of the gallbladder [3]. The gold standard treatment for acute cholecystitis is laparoscopic cholecystectomy (LC) [4]. A large body of research has demonstrated that LC in patients with early, well-compensated cirrhosis is safe and offers advantages over the open approach [5,6,7]. The cirrhotic background and severe inflammation may prolong the operative time and increase both blood loss and the conversion rate to an open procedure. Immediate LC is often a difficult and risky procedure in this patient group
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