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Article
November 1985

Cholecystectomy in Patients With Mild CirrhosisA More Favorable Situation

Author Affiliations

From the Departments of Surgery, Metropolitan Hospital Center, New York Medical College, New York (Drs Kogut and Ackerman), and Upstate Medical Center, State University of New York, Syracuse (Dr Aragoni).

Arch Surg. 1985;120(11):1310-1311. doi:10.1001/archsurg.1985.01390350090019
Abstract

• 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.

(Arch Surg 1985;120:1310-1311)

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