Lights off, camera on! Laparoscopic cholecystectomy improves outcomes in cirrhotic patients with acute cholecystitis

Background The best surgical approach to treat acute cholecystitis (AC) in cirrhotic patients is controversial. This study aimed to evaluate treatment options in cirrhotic patients with AC. We hypothesized that laparoscopic cholecystectomy (LC) would lead to better clinical outcomes when compared to...

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Bibliographic Details
Published in:Journal of hepato-biliary-pancreatic sciences 2022-03, Vol.29 (3), p.338-348
Main Authors: Finco, Tiago, Firek, Matthew, Coimbra, Bruno C., Brenner, Megan, Coimbra, Raul
Format: Article
Language:English
Subjects:
acute cholecystitis
Cholecystectomy
Cholecystectomy - adverse effects
Cholecystectomy, Laparoscopic - adverse effects
Cholecystitis, Acute - etiology
Cholecystitis, Acute - surgery
cirrhosis
Gallbladder diseases
Generalized linear models
Humans
laparoscopic cholecystectomy
Laparoscopy
Length of Stay
Liver cirrhosis
Liver Cirrhosis - complications
Liver Cirrhosis - surgery
Mortality
outcome
Postoperative Complications - surgery
Treatment Outcome
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Summary:Background The best surgical approach to treat acute cholecystitis (AC) in cirrhotic patients is controversial. This study aimed to evaluate treatment options in cirrhotic patients with AC. We hypothesized that laparoscopic cholecystectomy (LC) would lead to better clinical outcomes when compared to non‐operative management (NOM) and open cholecystectomy (OC), independent of the severity of liver cirrhosis. Methods Patients from the National Inpatient Sample diagnosed with AC were stratified into no cirrhosis (NC), compensated cirrhosis (CC), and decompensated cirrhosis (DC) and analyzed according to treatment: NOM, OC, and LC. Primary outcome was in‐hospital mortality. Secondary outcomes included hospital length of stay (HLOS), cost, and surgical complications. Univariate and multivariate analyses using generalized linear models were performed. A P 
ISSN:1868-6974
1868-6982
DOI:10.1002/jhbp.852