Laparoscopic surgery has been proved to be safe and better option for Child-Pugh (CP) score class I and II cirrhotic patients. Various challenging laparoscopic surgeries have been applied to this group of patients. This case report was of an obese man, CP class I alcoholic cirrhotic patient with radiological evidence of portal hypertension, inflicted with cecal adenocarcinoma. Laparoscopic right hemicolectomy was planned. First camera port incision was made on infraumbilical position and injured to large paraumbilical collateral, which drained blood from the main portal vein. The patient was survived but suffered from postoperative ascites and postponing definite surgery. The preoperative computed tomography was reviewed and detailed of these collateral vessels. This report aims to raise awareness of this potential complication and reveal the imaging with discussion of avoiding options.
Yerdel MA, Tsuge H, Mimura H, et al. Laparoscopic cholecystectomy in cirrhotic patients: expanding indications. Surg Laparosc Endosc 1993;3(3):180–183.
de Goede B, Klitsie PJ, Hagen SM, et al. Meta-analysis of laparoscopic versus open cholecystectomy for patients with liver cirrhosis and symptomatic cholecystolithiasis. Br J Surg 2013;100(2):209–216. DOI: 10.1002/bjs.8911.
Laurence JM, Tran PD, Richardson AJ, et al. Laparoscopic or open cholecystectomy in cirrhosis: a systematic review of outcomes and meta-analysis of randomized trials. HPB 2012;14(3):153–161. DOI: 10.1111/j.1477-2574.2011.00425.x.
Kim DJ, Park CH, Kim W, et al. Safety of laparoscopic radical gastrectomy in gastric cancer patients with liver cirrhosis. Surg Endosc 2017;31(10):3898–3904. DOI: 10.1007/s00464-017-5420-5.
Zhou S, Zhu H, Li Z, et al. Safety of laparoscopic resection for colorectal cancer in patients with liver cirrhosis: a retrospective cohort study. Int J Surg 2018;55:110–116. DOI: 10.1016/j.ijsu.2018.05.730.
Zhan XL, Ji Y, Wang YD. Laparoscopic splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension. World J Gastroenterol 2014;20(19):5794–5800. DOI: 10.3748/wjg.v20.i19.5794.
El-Awadi S, El-Nakeeb A, Youssef T, et al. Laparoscopic versus open cholecystectomy in cirrhotic patients: a prospective randomized study. Int J Surg 2009;7(1):66–69. DOI: 10.1016/j.ijsu.2008.10.013.
Hamad MA, Thabet M, Badawy A, et al. Laparoscopic versus open cholecystectomy in patients with liver cirrhosis: a prospective, randomized study. J Laparoendosc Adv Surg Tech A 2010;20(5): 405–409. DOI: 10.1089/lap.2009.0476.
Ji W, Li LT, Wang ZM, et al. A randomized controlled trial of laparoscopic versus open cholecystectomy in patients with cirrhotic portal hypertension. World J Gastroenterol 2005;11(16):2513–2517. DOI: 10.3748/wjg.v11.i16.2513.
Puggioni A, Wong LL. A metaanalysis of laparoscopic cholecystectomy in patients with cirrhosis. J Am Coll Surg 2003;197(6):921–926. DOI: 10.1016/j.jamcollsurg.2003.08.011.
Earl TM, Chapman WC. Nonhepatic surgery in the cirrhotic patient. In: Jarnagin W, ed. Blumgart's surgery of the liver, biliary tract and pancreas. 2, 6th ed., Elsevier; 2017. pp. 1161–1167.
Nguyen KT, Kitisin K, Steel J, et al. Cirrhosis is not a contraindication to laparoscopic cholecystectomy: results and practical recommendations. HPB (Oxford) 2011;13(3):192–197. DOI: 10.1111/j.1477-2574.2010.00270.x.
Moubarak E, Bouvier A, Boursier J, et al. Portosystemic collateral vessels in liver cirrhosis: a three-dimensional MDCT pictorial review. Abdom Imaging 2012;37(5):746–766. DOI: 10.1007/s00261-011-9811-0.
Palanisamy S, Sabnis SC, Patel ND, et al. Laparoscopic major hepatectomy-technique and outcomes. J Gastrointest Surg 2015;19(12):2215–2222. DOI: 10.1007/s11605-015-2933-x.