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KMID : 0978820090120020108
Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2009 Volume.12 No. 2 p.108 ~ p.112
Laparoscopic Cholecystectomy in Patients with a History of Upper Abdominal Surgery
Bae Young-Sik

Lee Sang-Mok
Kim Joo-Hyun
Kim Bum-Soo
Joo Sun-Hyung
Abstract
Purpose: Laparoscopic cholecystectomy is currently the treatment of choice for gallbladder disease. Previous abdominal surgery was considered as a relative contraindication for laparoscopic cholecystectomy due to the presence of intraabdominal adhesion and the difficulty in visualization. Several recent studies have suggested that previous abdominal surgery is no longer a contraindication for laparoscopic surgery by virtue of the accumulation of surgeons¡¯ experience and the evolution of laparoscopic instruments. In this study, we evaluated the impact of previous upper abdominal surgery on laparoscopic cholecystectomy.

Methods: The data of 706 consecutive patients who underwent laparoscopic cholecystectomy from September 2004 to December 2007 was retrospectively analyzed. Thirty-three patients had undergone pervious upper abdominal surgery and 673 patients had not. We compared the operative time, the type of trocar that was used, the postoperative complications, the frequency of open conversion and the length of the postoperative hospital stay between the two groups

Results: The operative time was longer (141.8¡¾88.7 min vs. 74.1¡¾37.4 min, p£¼0.001) and larger trocars were used more often (p£¼0.001) in the previous upper abdominal surgery group. There was no significant difference in the open conversion rate, the major postoperative complication rate and the length of the postoperative hospital stay.

Conclusion: Laparoscopic cholecystectomy might be an optimal treatment for patients with a history of previous upper abdominal surgery. Previous upper abdominal surgery is not a contraindication for laparoscopic cholecystectomy when it is performed by experienced laparoscopic surgeons.
KEYWORD
Laparoscopic cholecystectomy, Previous upper abdominal surgery
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