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Laparoscopic-assited colectomy in patients with liver cirrhosis

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Abstract

Background

Nonhepatic abdominal surgery, and especially colorectal surgery, is associated with high rates of morbidity and mortality among cirrhotic patients. With proper patient selection and preoperative optimization of the patient’s condition, laparoscopic-assisted colectomy could become effective and safe for patients with compensated liver cirrhosis. The aim of this study was to evaluate the safety and feasibility of minimal-access surgery in these patients.

Methods

Between September 1993 and March 2003, 820 patients underwent laparoscopic-assisted colectomy at our hospital. We studied all patients with liver cirrhosis who underwent this operation.

Results

Seventeen patients with cirrhosis were included in the study. Twelve were Child’s A and five were Child’s B. The mean operative time was 150 min (ranges 75–280), mean estimated blood loss was 245 ml (ranges 100—250). The conversion rate to open surgery was 29% (five patients). Median length of hospital stay was 5 days. The morbidity rate was 29% (five patients). There were no anastomotic leaks or operative-related deaths. The median follow-up was 21 months.

Conclusions

Laparoscopic-assisted colorectal surgery can be performed in compensated cirrhotic patients with low morbidity and mortality. Adequate patient selection and expertise in advanced minimal-access surgery are essential to obtain such good results.

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References

  1. MY Abdel-Atty O Farges P Jagot J Belghiti (1999) ArticleTitleLaparoscopy extends the indications for liver resection in patients with cirrhosis Br J Surg 86 1397–1400 Occurrence Handle10.1046/j.1365-2168.1999.01283.x Occurrence Handle1:STN:280:DC%2BD3c%2FltFWrsA%3D%3D Occurrence Handle10583285

    Article  CAS  PubMed  Google Scholar 

  2. GV Aranha HB Greenlee (1986) ArticleTitleIntra-abdominal surgery in patients with advanced cirrhosis Arch Surg 121 275–277 Occurrence Handle1:STN:280:BimC38bosF0%3D Occurrence Handle3947226

    CAS  PubMed  Google Scholar 

  3. M Braga A Vignali L Gianotti W Zuliani G Radaelli P Gruarin P Dellabona et al. (2002) ArticleTitleLaparoscopic versus open colorectal surgery: a randomized trial on short-term outcome Ann Surg 236 759–767 Occurrence Handle10.1097/00000658-200212000-00008 Occurrence Handle12454514

    Article  PubMed  Google Scholar 

  4. JR Clark VL Wills DR Hunt (2001) ArticleTitleCirrhosis and laparoscopic cholecystectomy Surg Laparosc Endosc Percutan Tech 11 165–169 Occurrence Handle10.1097/00019509-200106000-00003 Occurrence Handle1:STN:280:DC%2BD38%2FhvFegtw%3D%3D Occurrence Handle11444745

    Article  CAS  PubMed  Google Scholar 

  5. JA Olmo ParticleDel B Flor-Lorente B Flor-Civera F Rodriguez MA Serra A Escudero S Lledo et al. (2003) ArticleTitleRisk factors for nonhepatic surgery in patients with cirrhosis World J Surg 27 1647–652

    Google Scholar 

  6. A Dwivedi F Chahin S Agrawal WY Chau A Tootla F Tootla YJ Silva (2002) ArticleTitleLaparoscopic colectomy vs. open colectomy for sigmoid diverticular disease Dis Colon Rectum 45 1309–1315 Occurrence Handle12394427

    PubMed  Google Scholar 

  7. RN Garrison HM Cryer DA Howard HC Polk SuffixJr (1984) ArticleTitleClarification of risk factors for abdominal operations in patients with hepatic cirrhosis Ann Surg 199 648–655 Occurrence Handle1:STN:280:BiuB3s%2FisVA%3D Occurrence Handle6732310

    CAS  PubMed  Google Scholar 

  8. MM Knook EM Targarona J Garriga G Cerdan M Trias (2000) ArticleTitleApplicability of laparoscopic surgery for colorectal disease J Laparoendosc Adv Surg Tech A 10 263–268 Occurrence Handle1:STN:280:DC%2BD3crht12jtw%3D%3D Occurrence Handle11071406

    CAS  PubMed  Google Scholar 

  9. AM Lacy C Balaguer E Andrade JC Garcia-Valdecasas L Grande J FusterJ Bosch et al. (1995) ArticleTitleLaparoscopic cholecystectomy in cirrhotic patients: indication or contraindication? Surg Endosc 9 407–408 Occurrence Handle1:STN:280:ByqA1cbjtFY%3D Occurrence Handle7660263

    CAS  PubMed  Google Scholar 

  10. AM Lacy JC Garcia-Valdecasas S Delgado A Castells P Taura JM Pique J Visa (2002) ArticleTitleLaparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial Lancet 359 2224–2229 Occurrence Handle10.1016/S0140-6736(02)09290-5 Occurrence Handle12103285

    Article  PubMed  Google Scholar 

  11. A Mansour W Watson V Shayani J Pickleman (1997) ArticleTitleAbdominal operations in patients with cirrhosis: still a major surgical challenge Surgery 122 730–736 Occurrence Handle1:STN:280:DyaK1c%2FgslGguw%3D%3D Occurrence Handle9347849

    CAS  PubMed  Google Scholar 

  12. AM Metcalf RR Dozois BG Wolff RW Beart SuffixJr (1987) ArticleTitleThe surgical risk of colectomy in patients with cirrhosis Dis Colon Rectum 30 529–531 Occurrence Handle1:STN:280:BiiB2crpvVY%3D Occurrence Handle3595374

    CAS  PubMed  Google Scholar 

  13. DP Ondrula RL Nelson ML Prasad BW Coyle H Abcarian (1992) ArticleTitleMultifactorial index of preoperative risk factors in colon resections Dis Colon Rectum 35 117–122 Occurrence Handle1:STN:280:By2C3snpsFA%3D Occurrence Handle1735312

    CAS  PubMed  Google Scholar 

  14. HE Rice GE O’Keefe WS Helton K Johansen (1997) ArticleTitleMorbid prognostic features in patients with chronic liver failure undergoing nonhepatic surgery Arch Surg 132 880–885 Occurrence Handle1:STN:280:ByiH3M3mt1U%3D Occurrence Handle9267273

    CAS  PubMed  Google Scholar 

  15. D Sleeman N Namias D Levi FC Ward J Vozenilek R Silva JU Levi (1998) ArticleTitleLaparoscopic cholecystectomy in cirrhotic patients J Am Coll Surg 187 400–403 Occurrence Handle10.1016/S1072-7515(98)00210-5 Occurrence Handle1:STN:280:DyaK1cvlsFWjtQ%3D%3D Occurrence Handle9783786

    Article  CAS  PubMed  Google Scholar 

  16. K Tsugawa N Koyanagi M Hashizume M Tomikawa K Ayukawa K Akahoshi K Sugimachi (2001) ArticleTitleA comparison of an open and laparoscopic appendectomy for patients with liver cirrhosis Surg Laparosc Endosc Percutan Tech 11 189–194 Occurrence Handle10.1097/00019509-200106000-00008 Occurrence Handle1:STN:280:DC%2BD38%2FhvFensg%3D%3D Occurrence Handle11444750

    Article  CAS  PubMed  Google Scholar 

  17. JC Weeks H Nelson S Gelber D Sargent G Schroeder (2002) ArticleTitleShort-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial JAMA 287 321–328 Occurrence Handle10.1001/jama.287.3.321 Occurrence Handle11790211

    Article  PubMed  Google Scholar 

  18. CN Yeh MF Chen YY Jan (2002) ArticleTitleLaparoscopic cholecystectomy in 226 cirrhotic patients: experience of a single center in Taiwan Surg Endosc 16 l583–1587 Occurrence Handle10.1007/s00464-002-9026-0

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Institute of Digestive Diseases, Colorectal Cancer Unit, Hospital Clinic, University of Barcelona, Corporació Sanitària Clínic, Villarroel 170, Barcelona, 08036, Spain

    J. -L. Martínez, H. Rivas, S. Delgado & A. M. Lacy

  2. Department of Gastroenterology, Institute of Digestive Diseases, Colorectal Cancer Unit, Hospital Clinic, University of Barcelona, Corporació Sanitària Clínic, Villarroel 170, Barcelona, 08036, Spain

    A. Castells & J. M. Pique

Authors
  1. J. -L. Martínez
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  2. H. Rivas
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  3. S. Delgado
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  4. A. Castells
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  5. J. M. Pique
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  6. A. M. Lacy
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Correspondence to A. M. Lacy.

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Martínez, J.L., Rivas, H., Delgado, S. et al. Laparoscopic-assited colectomy in patients with liver cirrhosis. Surg Endosc 18, 1071–1074 (2004). https://doi.org/10.1007/s00464-003-9222-6

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  • DOI: https://doi.org/10.1007/s00464-003-9222-6

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