Skip to main content
SpringerLink
Log in

Laparoscopic cholecystectomy in patients with previous upper or lower abdominal surgery

  • Original article
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Background: Previous abdominal surgery has been reported as a relative contraindication to laparoscopic cholecystectomy. This study specifically examined the effect of previous intraabdominal surgery on the feasibility and safety of laparoscopic cholecystectomy. Methods: Data from 1,638 consecutive patients who underwent laparoscopic cholecystectomy were reviewed and analyzed for open conversion rates, operative times, intra- and postoperative complications, and hospital stay. Results: Of the 1,638 study patients 473 (28.9%) had undergone previous abdominal surgery: 58 upper and 415 lower abdominal operations. The 262 patients who had undergone only a previous appendectomy were excluded from further analysis. Adhesions were found in 70.7%, 58.8% and 2.1% of patients respectively, who had previous upper, lower or no previous abdominal surgery with adhesiolysis required, respectively, in 78%, 30% and 0% of these cases. There were no complications directly attributable to adhesiolysis. Patients with previous upper abdominal surgery had a longer operating time (66.4 ± 34.2 min), a higher open conversion rate (19%), a higher incidence of postoperative wound infection (5.2%), and a longer postoperative stay (3.4 ± 2.1 days) than those who had undergone previous lower abdominal surgery (50.8 ± 24 min, 3.3%, 0.7%, and 2.6 ± 1.4 days, respectively) and those without prior abdominal surgery (47.4 ± 25.6 min, 5.4%, 1.2%, and 2.8 ± 1.9 days, respectively). Conclusions: Previous abdominal operations, even in the upper abdomen, are not a contraindication to safe laparoscopic cholecystectomy. However, previous upper abdominal surgery is associated with an increased need for adhesiolysis, a higher open conversion rate, a prolonged operating time, an increased incidence of postoperative wound infection, and a longer postoperative stay.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. A Alponat CK Kum BC Koh A Rajnakova PM Goh (1997) ArticleTitlePredictive factors for conversion of laparoscopic cholecystectomy. World J Surg 21 629–633 Occurrence Handle1:STN:280:ByiA2svitFU%3D Occurrence Handle9230661

    CAS  PubMed  Google Scholar 

  2. JA Caprini JA Arcelus J Swanson R Coats K Hoffman JJ Brosnan S Blattner (1995) ArticleTitleThe ultrasonic localization of abdominal wall adhesions. Surg Endosc 9 283–285 Occurrence Handle1:STN:280:ByqA38%2FnsF0%3D Occurrence Handle7597599

    CAS  PubMed  Google Scholar 

  3. JM Childers PR Brzechffa EA Surwit (1993) ArticleTitleLaparoscopy using the left upper quadrant as the primary trocar site. Gynecol Oncol 50 221–225 Occurrence Handle10.1006/gyno.1993.1196 Occurrence Handle1:STN:280:ByyA1cjnvVw%3D Occurrence Handle8375738

    Article  CAS  PubMed  Google Scholar 

  4. J Diez R Delbene A Ferreres (1998) ArticleTitleThe feasibility of laparoscopic cholecystectomy in patients with previous abdominal surgery. HPB Surg 10 353–356 Occurrence Handle1:STN:280:DyaK1c7ns1ajtw%3D%3D Occurrence Handle9515231

    CAS  PubMed  Google Scholar 

  5. SL Goldstein BD Matthews RF Sing KW Kercher BT Heniford (2001) ArticleTitleLateral approach to laparoscopic cholecystectomy in the previously operated abdomen. J Laparoendosc Adv Surg Tech A 11 183–186 Occurrence Handle10.1089/109264201750539673 Occurrence Handle1:STN:280:DC%2BD3MritFCksw%3D%3D Occurrence Handle11569505

    Article  CAS  PubMed  Google Scholar 

  6. CH Hutchinson LW Traverso FT Lee (1994) ArticleTitleLaparoscopic cholecystectomy: preoperative factors predict the need to convert to open? Surg Endosc 8 875–878 Occurrence Handle1:STN:280:ByqD1cvislU%3D Occurrence Handle7992153

    CAS  PubMed  Google Scholar 

  7. RV Kolecki RM Golub B Sigel J Machi H Kitamura T Hosokawa J Justin J Schwartz HA Zaren (1994) ArticleTitleAccuracy of viscera slide detection of abdominal wall adhesions by ultrasound. Surg Endosc 8 871–874 Occurrence Handle1:STN:280:ByqD1cvislQ%3D Occurrence Handle7992152

    CAS  PubMed  Google Scholar 

  8. SS Kumar (1998) ArticleTitleLaparoscopic cholecystectomy in the densely scarred abdomen. Am Surg 64 1094–1096 Occurrence Handle1:STN:280:DyaK1M%2FhtlWhsw%3D%3D Occurrence Handle9798777

    CAS  PubMed  Google Scholar 

  9. R Marcovich MA Del Terzo JS Wolf Jr (2000) ArticleTitleComparison of transperitoneal laparoscopic access techniques: Optiview visualizing trocar and Veress needle. J Endourol 14 175–179 Occurrence Handle1:STN:280:DC%2BD3c3jtlCltw%3D%3D Occurrence Handle10772511

    CAS  PubMed  Google Scholar 

  10. J Mayol J Garcia-Aguilar E Ortiz-Oshiro JA De-Diego Carmona JA Fernandez-Represa (1997) ArticleTitleRisks of the minimal access approach for laparoscopic surgery: multivariate analysis of morbidity related to umbilical trocar insertion. World J Surg 21 529–533 Occurrence Handle1:STN:280:ByiA2cfotVE%3D Occurrence Handle9204743

    CAS  PubMed  Google Scholar 

  11. K Miller N Hölbling J Hutter W Junger E Moritz T Speil (1993) ArticleTitleLaparoscopic cholecystectomy for patients who have had previous abdominal surgery. Surg Endosc 7 400–403 Occurrence Handle1:STN:280:ByuD38vkvVc%3D Occurrence Handle8211616

    CAS  PubMed  Google Scholar 

  12. DA Ohl GJ Faerber WW Hurd (1994) ArticleTitleUrologic laparoscopy with a new blunt-tipped trocar: safe, rapid access without the use of fascial sutures. Urology 43 861–864 Occurrence Handle1:STN:280:ByuB2MrpvVE%3D Occurrence Handle8197651

    CAS  PubMed  Google Scholar 

  13. BD Schirmer J Dix RE Schmieg Jr M Aguilar S Urch (1995) ArticleTitleThe impact of previous abdominal surgery on outcome following laparoscopic cholecystectomy. Surg Endosc 9 1085–1089 Occurrence Handle1:STN:280:BymC3MfgvFw%3D Occurrence Handle8553208

    CAS  PubMed  Google Scholar 

  14. P Schrenk R Woisetschlager R Rieger WU Wayand (1998) ArticleTitleA diagnostic score to predict the difficulty of a laparoscopic cholecystectomy from preoperative variables. Surg Endosc 12 148–150 Occurrence Handle10.1007/s004649900616 Occurrence Handle1:STN:280:DyaK1c7ktVemtQ%3D%3D Occurrence Handle9479730

    Article  CAS  PubMed  Google Scholar 

  15. K Waxman DH Birkett JM Sackier J Este-McDonald J Duquette (1994) ArticleTitleClinical and laboratory evaluation of an electrosurgical laparoscopic trocar. Surg Endosc 8 1076–1079 Occurrence Handle1:STN:280:ByqD1cvivFM%3D Occurrence Handle7992179

    CAS  PubMed  Google Scholar 

  16. JS Wolf Jr (1997) ArticleTitleLaparoscopic access with a visualizing trocar. Tech Urol 3 34–37 Occurrence Handle1:STN:280:ByiA3Mzot1Y%3D Occurrence Handle9170223

    CAS  PubMed  Google Scholar 

  17. MD Wongworawat DR Aitken AE Robles C Garberoglio (1994) ArticleTitleThe impact of prior intraabdominal surgery on laparoscopic cholecystectomy. Am Surg 60 763–766 Occurrence Handle1:STN:280:ByqD3s%2FmsVI%3D Occurrence Handle7944039

    CAS  PubMed  Google Scholar 

  18. SC Yu SC Chen SM Wang TC Wei (1994) ArticleTitleIs previous abdominal surgery a contraindication to laparoscopic cholecystectomy? J Laparoendosc Surg 4 31–35 Occurrence Handle1:STN:280:ByuB38jislw%3D Occurrence Handle8173109

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Professor A. Zbar, University of the West Indies, Barbados, for critical revision of the manuscript.

Author information

Authors and Affiliations

  1. Second Department of Surgery, Democritus University of Thrace, Medical School, 6 I. Kaviri Street, 68 100 Alexandroupolis, Greece

    A. J. Karayiannakis, A. Polychronidis, S. Perente, S. Botaitis & C. Simopoulos

Authors
  1. A. J. Karayiannakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Polychronidis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Perente
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Botaitis
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C. Simopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. J. Karayiannakis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Karayiannakis, A., Polychronidis, A., Perente, S. et al. Laparoscopic cholecystectomy in patients with previous upper or lower abdominal surgery . Surg Endosc 18, 97–101 (2004). https://doi.org/10.1007/s00464-003-9001-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-003-9001-4

Keywords

Search

Navigation