Feasibility and Difficulties of Laparoscopic Cholecystectomy in Cirrhotic and Non-Alcoholic Fatty Livers: A Comparative Prospective Cohort Study

Abstract

Objective: To explore the effect of liver state on cholecystectomy which may help improving the pre-operative predisposing factors. This study is conducted to study the impact of fatty and cirrhotic livers on laparoscopic cholecystectomy and difficulties in the procedure, so we can modify correctable pre-operative factors.

Study design: a prospective cohort study.

Place and Duration of the Study: Department of General Surgery, Zagazig University, Egypt, between November 2024 to November 2025.

Methodology: This is a prospective cohort study included 72 patients who underwent laparoscopic cholecystectomy, divided into three groups: control (healthy or normal liver), fatty liver, and cirrhotic liver, each group contained 28 patients.

Results: The mean BMI was higher in the fatty liver group (31.7) with P< 0.001, pre- and post-operative liver enzymes and bilirubin were higher in cirrhotic and fatty liver groups. Group iii showed the highest values for operative time and bleeding with an inta operative time range of (79 – 200 minutes) and a mean bleeding amount of 172 ml. The cirrhotic group showed more post-operative drain discharge, longer hospital stay, and more pain score among the three groups.

Conclusion: Fatty and cirrhotic livers can affect the outcomes of laparoscopic cholecystectomy. Post-operative liver functions, operative time and bleeding, hospital stay, drain amount, and the pain score were statistically affected.