J Gastric Cancer.  2013 Dec;13(4):207-213.

Is Laparoscopy-assisted Radical Gastrectomy Safe in Patients with Child-Pugh Class A Cirrhosis?

• Kang SJ
• Jung MR
• Cheong O
• Park YK
• Kim HG
• Kim DY
• Kim HW
• Ryu SY

Abstract

PURPOSE
We investigated early postoperative morbidity and mortality in patients with liver cirrhosis who had undergone radical gastrectomy for gastric cancer.
MATERIALS AND METHODS
We retrospectively reviewed the medical records of 41 patients who underwent radical gastrectomy at the Chonnam National University Hwasun Hospital (Hwasun-gun, Korea) between August 2004 and June 2009. There were few patients with Child-Pugh class B or C; therefore, we restricted patient selection to those with Child-Pugh class A.
RESULTS
Postoperative complications were observed in 22 (53.7%) patients. The most common complications were ascites (46.3%), postoperative hemorrhage (22.0%) and wound infection (12.2%). Intra-abdominal abscess developed in one (2.4%) patient who had undergone open gastrectomy. Massive ascites occurred in 4 (9.8%) patients. Of the patients who underwent open gastrectomy, nine (21.9%) patients required blood transfusions as a result of postoperative hemorrhage. However, most of these patients had advanced gastric cancer. In contrast, most patients who underwent laparoscopic gastrectomy had early stage gastric cancer, and when the confounding effect from the different stages between the two groups was corrected statistically, no statistically significant difference was found. There was also no significant difference between open and laparoscopic gastrectomy in the occurrence rate of other postoperative complications such as ascites, wound infection, and intra-abdominal abscess. No postoperative mortality occurred.
CONCLUSIONS
Laparoscopic gastrectomy is a feasible surgical procedure for patients with moderate hepatic dysfunction.

Keyword

Stomach neoplasms; Liver cirrhosis; Gastrectomy

MeSH Terms

Abdominal Abscess
Ascites
Blood Transfusion
Fibrosis*
Gastrectomy*
Humans
Jeollanam-do
Liver Cirrhosis
Medical Records
Mortality
Patient Selection
Postoperative Complications
Postoperative Hemorrhage
Retrospective Studies
Stomach Neoplasms
Wound Infection

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