الفهرس 
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Abstract
In the beginning, liver cirrhosis was considered a contraindication for
laparoscopic cholecystectomy, mostly for the same reasons as for other
surgical procedures, i.e. mild to severe bleeding tendency, prolonged wound
healing due to hypoproteinemia, and various metabolic disorders.
Using correct operative indications, better opportunity, and reasonable
modality techniques, we can improve the curative effect and prognosis in
patients with cholelithiasis and liver cirrhosis.
The aim of the work is to compare between the rationale, risk and
complications of laparoscopic cholecystectomy (LC) versus open
cholecystetomy (OC) in cirrhotic patients.
Despite LC is difficult for cirrhotic patients, It is feasible and relatively
safe. To make LC successful in patients with cirrhosis, it is necessary for
surgeons to acquaint with technical characteristics of LC and emphasize
meticulous peri-operative management.
Laparoscopic cholecystectomy can be performed safely in selected
patients with cirrhosis Child–Pugh A and B who manifest indication for
surgery. Laparoscopic cholecystectomy offers several advantages over open
cholecystectomy: lower morbidity, shorter operative time, and reduced
hospital stay. In addition, complications are less with the laparoscopic
approach. This makes the outcome of cholecystectomies better with
laparoscopic than the open technique in patients with liver cirrhosis.
Nevertheless, because of the risk of development of liver insufficiency
and the risk of severe hemorrhage in patients with cirrhosis, we believe that
the indications for cholecystectomy in patients with cirrhosis should be
evaluated carefully. In patients with cirrhosis, LC should not be attempted by
surgeons without sufficient experience in laparoscopic surgery.