EFFICACY AND SAFETY OF LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH LIVER CIRRHOSIS

Аннотация

Cholecystectomy is the most common surgical intervention in patients with cirrhosis . It can be dangerous in end-stage liver disease and in portal hypertension due to the greater likelihood of serious complications, especially bleeding and hepatocellular insufficiency. Perhaps for this reason, HL was initially contraindicated in patients with cirrhosis. Later, with the accumulation of experience, as well as the improvement of equipment in laparoscopic surgery, the minimally invasive method gradually replaced open cholecystectomy in this group of patients and became the preferred intervention for cholelithiasis. Recent publications have confirmed the safety and good tolerability of HL in patients with compensated liver cirrhosis . The advantages of HL in cirrhosis are a reduction in the incidence of postoperative bleeding, infection, liver failure, and death . In this study, we presented our own experience of LC performed in 46 patients with compensated cirrhosis, paying special attention to the indications for this operation, the technique of intervention, and complications. The cause of cirrhosis in most of the patients we observed was hepatitis B and C. (32.6%) cirrhosis of the liver was an unexpected operational finding. The diagnosis of early cirrhosis before surgery for HL is not established, according to some authors, in 18.5-40% of cases .