Cholecystectomy in cirrhotic patients.

Cholecystectomy is the most common intraperitoneal operation done by general surgeons in this country and is generally considered safe. The incidence of cholelithiasis is doubled among cirrhotic patients, and biliary surgery in such patients carries tremendous risk, primarily due to excessive intraoperative hemorrhage. One author has reported a mortality of 83% among patients with severe cirrhosis having cholecystectomy. In this report, we review seven consecutive cirrhotic subjects having biliary surgery. There were no deaths. Blood loss roughly correlated with preoperative prothrombin times. Blood transfusions were required in five patients. Factors believed to improve operative outcome are discussed.