<p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> <p>To determine whether definitive surgery such as cholecysectomy or extraction of bile duct
stones is appropriate in cirrhotic patients the results of definitive surgery have been reviewed
retrospectively in a group of 112 cirrhotic patients with cholelithiasis. Eighty-seven of these
patients underwent definitive surgery for gallstones and the remaining 25 were treated
conservatively.</p> <p>Child's criteria were applied to each patient. Patients with Child's grade A disease had fewer emergency procedures, operative blood loss and transfusion were less and they had a shorter
hospital stay compared with patients with grades B and C. There were 4 deaths after definitive
surgery for emergency conditions and these were all in Child's grade C. Of the 83 survivors
after definitive procedures .78 patients (93.9%) were still alive 52.8 months later without any
biliary tract symptoms. Of the 25 patients undergoing conservative treatment 2 were Child's B
and 23 were Child's C grade.</p> <p>We suggest that definitive surgery can be carried out safely, in Child's A and B cirrhotic patients, either electively or as an emergency. However, a more conservative approach is advisable in Child C patients with acute conditions and definitive surgery is recommended as
an elective procedure after the liver function has improved.</p>
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HPB Surg. 1995; 9(1):43-46