Study: Laparoscopic surgery safer than open surgery among patients with cirrhosis

SAN DIEGO – Patients with cirrhosis who undergo laparoscopic surgery are less likely to experience adverse events and have shorter hospital stays than those who undergo open surgery, according to data presented at the 2012 Digestive Disease Week Annual Meeting.

Researchers performed a 10-year retrospective analysis on patients with cirrhosis who underwent laparoscopic or open abdominal and pelvic surgery at a single facility. Evaluated factors included Child’s and MELD scores, adverse events and the length of post-operative hospital stays.

Among 165 patients, 133 underwent open and 32 underwent laparoscopic surgery, with similar baseline characteristics between the two groups. The open surgery group had 52 patients with Child’s class A, 70 with class B and 11 with class C, while the laparoscopic group had 24 with class A, 6 with class B and 2 with class C. Average MELD scores in the two groups were 11.5 (range 5-32) in the open group and 9.8 (range 6-22) in the laparoscopic group.

Patients were significantly less likely to experience adverse events in the laparoscopic group compared with the open group (9.4% of patients vs. 27.1%, P=.037). The laparoscopic group also experienced significantly shorter hospital stays (2.3 vs. 6.5 days, P=.006). Investigators also observed a lower likelihood of death, hepatic decompensation and other post-operative complications in the laparoscopic group. There was also no statistically significant difference between Child’s or MELD scores or in surgical outcomes based on the scores between groups.

“Part of the driving force behind doing the study was how poorly [patients with cirrhosis] do in surgery overall,” researcher Aditya Dholakia, DO, told Healio.com. “It does look like patients undergoing laparoscopy appear to do a little bit better than the patients undergoing open abdominal or pelvic procedures, but you can’t say too much about the difference between the surgeries as the Child’s or MELD score goes up, the difference between the surgeries.” Dholakia added that additional study using a larger patient population would be warranted.

For more information:

Dholakia A. #Sa1010: Outcomes and Safety of Open vs. Laparoscopic Surgery in Patients with Cirrhosis. Presented at: the 2012 Digestive Disease Week Annual Meeting; May 19-22, 2012; San Diego.