Laparoscopic cholecystectomy in patients with liver cirrhosis: 8 years experience in a tertiary center. A retrospective cohort study

Conclusion: LC can be safely performed in cirrhotic patients. However, higher CTP and MELD scores, operative bleeding, more blood and plasma transfusion units, longer operative time, lower platelet count, and higher INR values are predictors of poor outcome that can be improved by proper patient selection and meticulous peri-operative care and by using Harmonic scalpel shears.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research

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dquo; Study Group Investigators Abstract BACKGROUND: Current guidelines do not address the post-sustained virological response management of patients with baseline hepatitis C virus (HCV) cirrhosis and oesophageal varices taking betablockers as primary or secondary prophylaxis of variceal bleeding. We hypothesized that in some of these patients portal hypertension drops below the bleeding threshold after sustained virological response, making definitive discontinuation of the betablockers a safe option. AIM: To assess the evolution of portal hypertension, associated factors, non-invasive assessment, and risk ...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
Conclusion Massive SI and immune cell paralysis associated with ACLF represent the extreme severity of CAID in response to an infectious or sterile challenge. The severe immune disturbance plays a pivotal role in the pathogenesis of the distinctive features of ACLF: organ failure and bacterial infection susceptibility. Excessive SI in ACLF results from the massive activation and dysfunction of an innate immune system challenged by increased PAMPs and DAMPs. SI leads to cell and tissue immunopathology contributing to hepatic and extrahepatic organ failure. Concomitantly, the course of ACLF is associated with a disproportio...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
ConclusionsUltrasound ‐guided liver biopsies of indeterminate lesions in patients at high risk of HCC yield important histopathological findings, important for management options including the provision of curative treatments and assisting future novel therapies such as immunotherapy and targeted therapies. The low com plication rates confirm its safety and the procedure should not be avoided for fear of complications.
Source: Journal of Medical Imaging and Radiation Oncology - Category: Radiology Authors: Tags: Medical Imaging —Original Article Source Type: research
Abstract BACKGROUND: Current guidelines recommend screening of people with oesophageal varices via oesophago-gastro-duodenoscopy at the time of diagnosis of hepatic cirrhosis. This requires that people repeatedly undergo unpleasant invasive procedures with their attendant risks, although half of these people have no identifiable oesophageal varices 10 years after the initial diagnosis of cirrhosis. Platelet count, spleen length, and platelet count-to-spleen length ratio are non-invasive tests proposed as triage tests for the diagnosis of oesophageal varices. OBJECTIVES: Primary objectives To determine the dia...
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
Chronic liver diseases (CLD) are very common: worldwide, an estimated 160 million people have chronic hepatitis C [1], 240 million have chronic hepatitis B [2], and 25% of the general population has non-alcoholic fatty liver disease (NAFLD) [3]. CLD can lead to a progressive accumulation of fibrosis in the liver which progressively evolves to cirrhosis and its life-threatening complications such as hepatocellular carcinoma (HCC), liver failure, variceal bleeding, or renal insufficiency. In 2012, driven by the growing worldwide burden of CLD, cirrhosis was responsible for more than 35 million years of lost life and thus bec...
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Research Article Source Type: research
Chronic liver diseases (CLD) are very common: worldwide, an estimated 160 million people have chronic hepatitis C [1], 240 million have chronic hepatitis B [2], and 25% of the general population has non-alcoholic fatty liver disease (NAFLD) [3]. CLD can lead to a progressive accumulation of fibrosis in the liver which progressively evolves to cirrhosis and its life-threatening complications such as hepatocellular carcinoma (HCC), liver failure, variceal bleeding, or renal insufficiency. In 2012, driven by the growing worldwide burden of CLD, cirrhosis was responsible for more than 35 million years of lost life and thus bec...
Source: Journal of Hepatology - Category: Gastroenterology Authors: Source Type: research
Abstract Statins are a class of molecules that inhibit HMG CoA reductase. They are usually prescribed as a lipid lowering medication. However, there is accumulating evidence that statins have multiple secondary effects both related and unrelated to their lipid-lowering effect. This narrative review of the literature aims to provide the reader with information from clinical studies related to the effect of statin and statins' potential use in patients with liver diseases. In patients with advanced liver disease due to any etiology, statins exhibit an antifibrotic effect possibly through the prevention of hepatic si...
Source: World Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
Abstract Thrombocytopenia (platelet count
Source: Drugs - Category: Drugs & Pharmacology Source Type: research
This article provides a review on the most up to date data on the use of DAA’s in patients with advanced fibrosis and cirrhosis. We are at a point where HCV could be truly eradicated, but to do so will require ensuring there are effective and safe treatments for those with advanced fibrosis and cirrhosis.
Source: Therapeutic Advances in Chronic Disease - Category: Internal Medicine Authors: Tags: Reviews Source Type: research
Portal hypertension is a common complication of chronic liver disease. Its relevance comes from the fact that it determines most complications leading to death or liver transplantation in patients with cirrhosis of the liver: bleeding from esophageal or gastric varices, ascites and renal dysfunction, sepsis and hepatic encephalopathy. Portal hypertension results from increased resistance to portal blood flow through the cirrhotic liver. This is caused by two mechanisms: (1) distortion of the liver vascular architecture due to the liver disease causing structural abnormalities (nodule formation, remodeling of liver sinusoid...
Source: Digestive Diseases - Category: Gastroenterology Source Type: research
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