Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Upper Abdominal Surgery

Abstract

Background and aim There is still a considerable percentage of patients in whom laparoscopic cholecystectomy (LC) cannot be successfully performed and conversion to open surgery is required. The potential risks have dissuaded some surgeons from using the laparoscopic procedure in patients with symptomatic gallstones and previous upper abdominal surgery (UAS). The aim of this study is to investigate the impact of previous UAS on the successful performance of LC. Patients and methods Between September 2016 and September 2017, 50 patients with previous UAS and symptomatic cholelithiasis were subjected to LC. Intraoperative data regarding difficulties, duration of surgery, rate of conversion, and any incidental postoperative event were recorded. Results No mortality occurred. Adhesiolysis was not required in all cases. There were no complications directly attributable to adhesiolysis. Postoperative complications occurred in 12 (24%) patients. The procedure was completed laparoscopically in 44 patients with a 12% conversion rate. Conclusion Previous UAS is not a contraindication to safe LC, but is associated with an increased need for adhesiolysis, a longer operative time, an increased open conversion rate, and sometimes a larger number of trocars.