Outcomes of Laparoscopic Cholecystectomy in patients with Previous Upper Abdominal Surgery

Document Type : Original Article

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Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt

Abstract

Background: Previous upper abdominal surgery was considered a contraindication to laparoscopic cholecystectomy; Patients who have had surgery in the upper abdomen were advised against having laparoscopy due to the creation of adhesions and the challenge of seeing the gallbladder. This raises the risk of harm to the bowel or blood vessels caused by the first trocar. This study aims to evaluate the possibility and results of laparoscopic cholecystectomy in patients who had previously had surgery in the upper abdomen. Subjects and Methods: This prospective study was conducted at the General Surgery Department of Zagazig University Hospital. Thirty patients with gallstone disease (13 males and 17 females), aged 30–62 years with a mean age of 47.03±7.61 years, all of whom had a previous upper abdominal incision and were subjected to laparoscopic cholecystectomy. Results: In our study, laparoscopic cholecystectomy was feasible and completed safely in 27 patients, while in 3 patients, it was converted to open cholecystectomy due to intra abdominal adhesions; we failed to create pneumoperitoneum in one of the converted cases; in another patient, there were dense adhesions in the periportal area, and the last patient to be converted was due to small intestine injury, which was managed by direct repair of the injury. Conclusion: Patients with previous upper abdominal surgeries reported difficulties during their procedure of laparoscopic cholecystectomy, but only those who had prior major abdominal surgery and incisions near the cholecystectomy laparoscopic area reported longer operating times, higher rates of conversion, high-grade adhesions, and longer hospital stays.

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Zagazig University Medical Journal

Articles in Press, Accepted Manuscript
Available Online from 23 March 2024

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