Surgery Today

, Volume 38, Issue 9, pp 790–794 | Cite as

Laparoscopic cholecystectomy in patients with a history of gastrectomy

  • Akira Sasaki
  • Jun Nakajima
  • Hiroyuki Nitta
  • Toru Obuchi
  • Shigeaki Baba
  • Go Wakabayashi
Original Article



Previous gastrectomy has been considered a relative contraindication to laparoscopic cholecystectomy (LC). The aim of this study was to evaluate the safety and efficacy of LC in patients with a history of gastrectomy.


From a database of 1 104 consecutive patients with symptomatic gallstone disease, who underwent LC between April 1992 and January 2007, 51 (4.6%) had undergone previous gastrectomy: for gastric cancer (n = 36) or gastroduodenal ulcer (n = 15). We compared the operative time, blood loss, conversion rate, morbidity rate, diet resumption, and postoperative hospital stay between patients with, and those without, a history of gastrectomy.


The incidence of common bile duct stones was significantly higher (33.3% vs 8.6%, P < 0.001) and operative time was significantly longer (111.2 min vs 77.9 min, P < 0.001) in the patients with a history of gastrectomy. There was no significant difference in operative time between the first-half and second-half periods. Conversion to an open cholecystectomy was required in two patients. There was no significant difference between the two groups in blood loss, conversion rate, morbidity rate, diet resumption, or postoperative hospital stay.


Laparoscopic cholecystectomy is a safe and effective treatment for symptomatic gallstone disease in patients with a history of gastrectomy, although previous gastrectomy is associated with an increased need for adhesiolysis and a longer operative time.

Key words

Laparoscopic cholecystectomy Previous surgery Gastrectomy Gallstone 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Perissat J, Collet D, Belliard R. Gallstones: laparoscopic treatment — cholecystectomy, cholecystomy, and lithotripsy. Surg Endosc 1990;4:1–5.PubMedCrossRefGoogle Scholar
  2. 2.
    Schirmer BD, Edge ST, Dix J, Hyser MJ, Hanks JB, Jones RS. Laparoscopic cholecystectomy. Treatment of choice for symptomatic cholelithiasis. Ann Surg 1991;213:665–676.PubMedCrossRefGoogle Scholar
  3. 3.
    Hutchinson CH, Traverso LW, Lee FT. Laparoscopic cholecystectomy. Do preoperative factors predict the need to convert to open? Surg Endosc 1994;8:875–880.PubMedCrossRefGoogle Scholar
  4. 4.
    Frazee RC, Roberts JW, Symmonds R, Suyder SK, Hendricks J, Smith R. What are the contraindications for laparoscopic cholecystectomy? Am J Surg 1992;164:491–495.PubMedCrossRefGoogle Scholar
  5. 5.
    Wongworawat MD, Aitken DR, Robles AE, Garberoglio C. The impact of prior intraabdominal surgery on laparoscopic cholecystectomy. Am Surg 1994;60:763–766.PubMedGoogle Scholar
  6. 6.
    Yu SC, Chen SC, Wang SM, Wei TC. Is previous abdominal surgery a contraindication to laparoscopic cholecystectomy? J Laparoendosc Surg 1994;4:31–35.PubMedGoogle Scholar
  7. 7.
    Diez J, Delbence R, Ferreres A. The feasibility of laparoscopic cholecystectomy in patients with previous abdominal surgery. HPB Surg 1998;10:353–356.PubMedCrossRefGoogle Scholar
  8. 8.
    Sasaki A, Asahi H, Shimada Y, Kawamura H, Nakajima J, Saito K. Laparoscopic cholecystectomy (in Japanese). Syujyutsu (Jpn J Operation) 2004;58:1009–1014.Google Scholar
  9. 9.
    Kumar SS. Laparoscopic cholecystectomy in the densely scarred abdomen. Am Surg 1998;64:1094–1096.PubMedGoogle Scholar
  10. 10.
    Miyajima N, Kasugai H, Morita H, Takahashi K, Takahashi S, Doyohshita K. Laparoscopic cholecystectomy in patients with previous gastrectomy (in Japanese). Nihon Naishikyogeka Gakkaizasshi (JSES) 2000;5:225–228.Google Scholar
  11. 11.
    Kwon AH, Inui H, Imamura A, Kaibori M, Kamiyama Y. Laparoscopic cholecystectomy and choledocholithotomy in patients with a previous gastrectomy. J Am Coll Surg 2001;193:614–619.PubMedCrossRefGoogle Scholar
  12. 12.
    Akyurek N, Salman B, Irkorucu O, Tascilar O, Yuksel O, Sare M, et al. Laparoscopic cholecystectomy in patients with previous abdominal surgery. JSLS 2005;9:178–183.PubMedGoogle Scholar
  13. 13.
    Jorgensen JO, Hunt DR. Laparoscopic cholecystectomy. A prospective analysis of the potential causes of failure. Surg Laparosc Endosc 1993;3:49–53.PubMedGoogle Scholar
  14. 14.
    Karayiannakis AJ, Polychronidis A, Perente S, Botaitis S, Simopoulos C. Laparoscopic cholecystectomy in patients with previous upper or lower abdominal surgery. Surg Endosc 2004;18:97–101.PubMedCrossRefGoogle Scholar
  15. 15.
    Miller K, Holbling N, Hutter J, Junger W, Moritz E, Speil T. Laparoscopic cholecystectomy for patients who have had previous abdominal surgery. Surg Endosc 1993;7:400–403.PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2008

Authors and Affiliations

  • Akira Sasaki
    • 1
  • Jun Nakajima
    • 1
  • Hiroyuki Nitta
    • 1
  • Toru Obuchi
    • 1
  • Shigeaki Baba
    • 1
  • Go Wakabayashi
    • 1
  1. 1.Department of SurgeryIwate Medical University School of MedicineMoriokaJapan

Personalised recommendations