The feasibility of laparoscopic cholecystectomy in patients with previous abdominal surgery.

J Diez,A Ferreres,R Delbene

doi:10.1155/1998/35456

Abstract

A retrospective study was carried in 1500 patients submitted to elective laparoscopic cholecystectomy to ascertain its feasibility in patients with previous abdominal surgery. In 411 patients (27.4%) previous infraumbilical intraperitoneal surgery had been performed, and 106 of them (7.06%) had 2 or more operations. Twenty five patients (1.66%) had previous supraumbilical intraperitoneal operations (colonic resection, hydatid liver cysts, gastrectomies, etc.) One of them had been operated 3 times. In this group of 25 patients the first trocar and pneumoperitoneum were performed by open laparoscopy. In 2 patients a Marlex mesh was present from previous surgery for supraumbilical hernias. Previous infraumbilical intraperitoneal surgery did not interfere with laparoscopic cholecystectomy, even in patients with several operations. There was no morbidity from Verres needle or trocars. In the 25 patients with supraumbilical intraperitoneal operations, laparoscopic cholecystectomy was completed in 22. In 3, adhesions prevented the visualization of the gallbladder and these patients were converted to an open procedure. In the 2 patients Marlex mesh prevented laparoscopic cholecystectomy because of adhesions to abdominal organs. We conclude that in most instances previous abdominal operations are no contraindication to laparoscopic cholecystectomy.

Highlights

The records of 1500 consecutive patients treated by laparoscopic cholecystectomy between De-Araoz *Av
No intraoperative or postoperative complications resulted from the insertion of the Verress needle or the trocars
Previous abdominal surgery was once considered a contraindication to laparoscopic cholecystectomy

Summary

Introduction

Previous abdominal surgery may increase the difficulty of laparoscopic cholecystectomy [20, 16, 17] especially in upper abdominal operations [11,15]. Many surgeons, have found that the procedure can often be safely performed, but there have been few studies that have examined this subject .in detail [2, 5, 7, 16, 19] The purpose of this retrospective study is to examine the influence of previous upper and lower abdominal surgery on the performance of laparoscopic cholecystectomy in a University and private clinic.

Results

Discussion

Conclusion