The Application Value Of Liver Function And Gallbladder Factors Assessment In Laparoscopic Cholecystectomy For Cholecystitis With Cirrhosis

Objective:To analyze and summarize the application value of liver function evaluation and gallbladder factors in laparoscopic cholecystectomy for chronic cholecystitis with liver cirrhosis,for provide reference basis for surgical treatment.Methods:In this study,a total of 73 patients underwent laparoscopic cholecystectomy with chronic cholecystitis combined with liver cirrhosis during the 2013.01-2016.06 period and the patients were retrospectively analyzed and recorded.The effects of Child-Pugh grading and MELD scoring system on preoperative evaluation were evaluated from the aspects of operation time,intraoperative blood loss,transit rate and occurrence of postoperative hospital stay.And evaluate the effect of gallbladder factors on surgery from the gallbladder wall thickening,the number of gallstones and gallbladder atrophy and other aspects.Results:MELD score> 14 group was statistically different compared with MELD score <14 in operation time,intraoperative bleeding,conversion to laparotomy,complication and postoperative hospitalization(P<0.05).There was no significant difference between Child A and Child B in terms of statistical difference in other respects above(p>0.05),except postoperative hospitalization day(p <0.05).There are statistical differences of gallbladder wall thickness in the operation time,intraoperative bleeding,transit rate and complications(p <0.05),and no statistical differences in the number of gallstones and gallbladder atrophy(p>0.05).In addition,the degree of gallbladder wall thickening was positively correlated with Child-Pugh grade(rs = 0.289 p <0.05)and MELD scoring system(rs = 0.267 p <0.05).Conclusion:Laparoscopic cholecystectomy is a safe and feasible procedure for patients with chronic cholecystitis complicated with cirrhosis.However cirrhosis with chronic cholecystitis as a special type of cholecystitis,there is important significance of scientific preopetative assessment in the surgical program plan and prognosis judgement.The results of this study show that the preoperative evaluation value of MELD scoring system is superior to Child-Pugh grading and the degree of gallbladder wall thickening is also good for preoperative evaluation.The number of gallstones does not have a good predictive effect on the operation.Although gallbladder atrophy did not show a statistically significant difference in this study,we should be pay attention to the effect of this factor on surgery.