Posterior Wall Sparing of Laparoscopic Cholecystectomy in Cirrhotic Patients

NCT ID: NCT06778928

Last Updated: 2025-01-16

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 60 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2025-01-31
• Study Completion Date: 2026-04-01

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.

Conditions

Cholecystitis in Cirrhotic Patients

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Posterior wall sparing of laparoscopic cholecystectomy in cirrhotic patients

To assess the outcome of posterior wall sparing of laparoscopic cholecystectomy in cirrhotic patient

laparoscopic cholecystectomy

Intervention Type: PROCEDURE

Posterior wall sparing of laparoscopic cholecystectomy in cirrhotic patients

Interventions

laparoscopic cholecystectomy

Posterior wall sparing of laparoscopic cholecystectomy in cirrhotic patients

Intervention Type: PROCEDURE

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Assiut University

OTHER

Sponsor Role: lead

Responsible Party

Adnan mohamed

Principal investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Central Contacts

Adnan mohamed Mohamed Mohamed salem

Role: CONTACT

Adnan.16281240@med.aun.edu.eg

01111846484

Mostafa Mahmoud Mohamed Ibrahim, Lecturer

Role: CONTACT

mostafamahmoud562@au.edu.eg

01095295794

References

Shaikh AR, Muneer A. Laparoscopic cholecystectomy in cirrhotic patients. JSLS. 2009 Oct-Dec;13(4):592-6. doi: 10.4293/108680809X12589999537959.

Reference Type: BACKGROUND

PMID: 20202403 (View on PubMed)

Schiff J, Misra M, Rendon G, Rothschild J, Schwaitzberg S. Laparoscopic cholecystectomy in cirrhotic patients. Surg Endosc. 2005 Sep;19(9):1278-81. doi: 10.1007/s00464-004-8823-z. Epub 2005 Jul 21.

Reference Type: BACKGROUND

PMID: 16021366 (View on PubMed)

Palanivelu C, Rajan PS, Jani K, Shetty AR, Sendhilkumar K, Senthilnathan P, Parthasarthi R. Laparoscopic cholecystectomy in cirrhotic patients: the role of subtotal cholecystectomy and its variants. J Am Coll Surg. 2006 Aug;203(2):145-51. doi: 10.1016/j.jamcollsurg.2006.04.019. Epub 2006 Jun 22.

Reference Type: BACKGROUND

PMID: 16864026 (View on PubMed)

Cassinotti E, Baldari L, Boni L, Uranues S, Fingerhut A. Laparoscopic Cholecystectomy in the Cirrhotic: Review of Literature on Indications and Technique. Chirurgia (Bucur). 2020 Mar-Apr;115(2):208-212. doi: 10.21614/chirurgia.115.2.208.

Reference Type: BACKGROUND

PMID: 32369724 (View on PubMed)

Other Identifiers

cholecystectomy cirrhotic

Identifier Type: -

Identifier Source: org_study_id