Posterior Wall Sparing of Laparoscopic Cholecystectomy in Cirrhotic Patients

Not yet recruiting

• Conditions: Cholecystitis in Cirrhotic Patients

• Registration Number: NCT06778928
• Lead Sponsor: Assiut University

Brief Summary

To assess the outcome of posterior wall sparing of laparoscopic cholecystectomy in cirrhotic patients in Assuit university hospitals and El Rajhi hospital.

Detailed Description

Cholelithiasis is found in about one third of patients with liver cirrhosis and about twice as much as in the overall population. Predisposing factors for that include functional gallbladder alterations (reduced motility and decreased emptying), reduction in bile acidity, increased unconjugated bilirubin secretion, increased levels of estrogen, and increased intravascular haemolysis due to hypersplenism. Symptomatic biliary stones in patients with liver cirrhosis are associated with higher morbidity and mortality rates than those in patients with a non-cirrhotic liver. laparoscopic cholecystectomy is the gold standard for the treatment of most of gallbladder problems because of its several advantages over open cholecystectomy including shorter convalescence period and hospital stay. Furthermore, considering its safety, it is the gold-standard procedure in selected patients with symptomatic cholelithiasis and hepatic cirrhosis, especially Child-Pugh score A and B patients. Separation of posterior wall of the gallbladder from the liver bed in cirrhotic individuals is difficult and risky during a laparoscopic cholecystectomy surgery because of high-risk gall bladder bed due to fibrosis and tortuous, dilated vessels there so the strategy is leaving the posterior wall intact with the liver and the remnant mucosa was removed either by mucosectomy in patients with acute cholecystitis or by electro fulguration in those with chronic cholecystitis.

Study Timeline

• Status Verified: 2024-10
• Study First Submitted: 2024-10-11
• Study Start: 2025-01
• Study First Submitted QC: 2025-01-11
• Last Update Submitted: 2025-01-11
• Study First Posted: 2025-01-16
• Last Update Posted: 2025-01-16
• Primary Completion: 2026-04-01
• Study Completion: 2026-04-01

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• Patient age 18 - 60 years old Child A and B cirrhotic patients with Cholelithiasis Patient fit for surgery

Exclusion Criteria

• Patient with pervious abdominal surgery

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Intra and Post-operative haemorrhage	Surgery then 2 days follow up
Postoperative bile leak	Surgery then 1 week follow up
Changes of liver function tests	Surgery then 1 week follow up	AST, ALT, Billirubin
Worsening of ascites	Surgery then 1 week follow up
Port site infection	Surgery then 1 week folow up

Secondary Outcome Measures

Name	Time	Method
Operative time	From the end of induction of anasthesia to the closure of port site incisions
Postoperative hospital stay	surgery then up to 1 week hospital stay before discharge