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Euro Gastroenterology 2019 & Clinical Pharmacy 2019 Archives of General Internal Medicine | ISSN: 2591-7951 | Volume 3
Page 52
March 25-26, 2019 | Amsterdam, Netherlands
&
GASTROENTEROLOGY AND HEPATOLOGY
4th International Conference on
CLINICAL PHARMACY & PHARMACY PRACTICE
9th World Congress on
Joint Event on
OF EXCELLENCE
IN INTERNATIONAL
MEETINGS
YEARS
LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH LIVER CIRRHOSIS:
8 YEARS EXPERIENCE IN A TERTIARY CENTRE AND THE RULE OF HARMONIC
DEVICE
Emad Hamdy Gad, Yasmin Kamel, Ayman Alsebaey, Anwar Mohamed, Ali Nada and Mo-
hammed Alsayed Abdelsamee
Menoufia University, Egypt
Objectives: With improved laparoscopic techniques and experience, availability of newer tools and instruments
like ultrasonic shears; Laparoscopic Cholecystectomy (LC) became feasible option in cirrhotic patients, the aim
of this study was to analyze the outcome of LC in cirrhotic patients, and the rule of harmonic device.
Patients and Methods: We retrospectively analyzed 213 cirrhotic patients underwent LC, in the period from
2011 to 2019, the overall male /female ratio was 114/99.
Results: The most frequent CTP score was A, The most frequent cause of cirrhosis was HCV, while biliary colic
was the most frequent presentation. Harmonic device was used in around 40% of patients, and on comparing
patients with and without harmonic use, there were significant lower operative bleeding, less amount of blood
and plasma transfusion, shorter operative time and hospital stay, and lower conversion and morbidity rates in
the former. The morbidity was around 22% while mortality was around 2%, and morbidity significant predictors
were CTP score B, C, non-harmonic group, operative bleeding, increased MELD score, blood and plasma transfu-
sion units, lower platelet count and longer operative time.
Conclusion: LC can be safely performed in cirrhotic patients with appropriate patient selection. However, op-
erative bleeding, increased blood and plasma transfusion units, CTP and MELD scores are predictors of poor
outcome that can be improved by using harmonic scalpel shears.
Keywords: Laparoscopic cholecystectomy, Liver cirrhosis, Harmonic device
Emad Hamdy Gad et al., Arch Gen Intern Med 2019, Volume 3 | DOI: 10.4066/2591-7951-C1-023
Emad Hamdy Gad is currently working as an associate professor of surgery in the department of transplantation, hepa-
tobiliary & pancreatic surgery at National Liver Institute, University of Minoufiya, Shibin El-Kom, Minoufiya, Egypt and
consultant in general surgery and hepatobiliary surgery in King Faisal Hospital, Taif, KSA. He worked as specialist in gen­
eral surgery in Alganzoury Private Hospital in Cairo, Egypt from 2008 to 2014 (part time). He also worked as consultant
in hepatopancreatobiliary and laparoscopic surgery in King Khaled Hospital (General Surgery and Trauma Hospital) in
Hail in KSA for 6 months (Locum) from 2/ 2015 to 8/2015. He worked as consultant in general surgery in Alnile Hospital,
Gherghada, Egypt from 3/2016 until 8/2016.
BIOGRAPHY