Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Upper Abdominal Surgery
Background: Previous abdominal surgery usually lead to adhesion formation, which considered as a contraindication of laparoscopic cholecystectomy (LC). However, it had been reported that, careful adhesiolysis could be performed and thus LC becomes feasible. Aim of the work: To assess the feasibility...
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2021-04-01
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doaj-af65284b5f674766b5a6bbb18ff2d16e2021-05-15T15:45:15ZengEgyptian knowledge bankInternational Journal of Medical Arts2636-41742682-37802021-04-01321482149310.21608/ijma.2021.45006.1186159220Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Upper Abdominal SurgeryHamdy Ahmed Mostafa salama0Salah Ayoub Soliman1Ayman Fahmy Elramah2Department of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, EgyptDepartment of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, EgyptDepartment of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, EgyptBackground: Previous abdominal surgery usually lead to adhesion formation, which considered as a contraindication of laparoscopic cholecystectomy (LC). However, it had been reported that, careful adhesiolysis could be performed and thus LC becomes feasible. Aim of the work: To assess the feasibility and outcome of laparoscopic cholecystectomy in patients with previous upper abdominal surgery. Patients and Methods: This study included 30 patients, who were presented by symptomatic gallstones. All participants assessed clinically. Then, a full lab profile was performed. Finally, abdominal ultrasound was done and if there was a dilatation of common bile duct, patients were submitted to magnetic resonance cholangiopancreatography. Both intra-and postoperative data were collected and any complications were documented.Results: 26 patients (86.7%) had chronic calcular cholecystitis, two had acute calcular cholecystitis and two had mucocele of gallbladder. Adhesions were grade 1 in 13.3%, grade 2 in 46.7%, grade 3 in 20% and grade 4 in 20.0%. Adhesiolysis was needed in twenty patients (66.7%). Intraoperative complications were reported in nine patients (40%). Bleeding reported in six patients and preformation of the gall bladder in three patients (10%). Three patients (10%) were converted to open surgery. Postoperatively, 12 patients (26.7%) had complications [3, 1, 2, 1 and 5 for port site wound infection, bile leakage, bleeding, and chest infection respectively). Post operative pain was mild in half of patients and moderate in other half. Conclusion: laparoscopic cholecystectomy after previous abdominal operations is relatively feasible and relatively safe, as nearly one third of patients had difficulties and complications.https://ijma.journals.ekb.eg/article_159220_228ef77a6f478eb79d03e389db7f8b60.pdflaparoscopic cholecystectomyadhesionsfeasibilityupper abdomensurgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hamdy Ahmed Mostafa salama Salah Ayoub Soliman Ayman Fahmy Elramah |
spellingShingle |
Hamdy Ahmed Mostafa salama Salah Ayoub Soliman Ayman Fahmy Elramah Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Upper Abdominal Surgery International Journal of Medical Arts laparoscopic cholecystectomy adhesions feasibility upper abdomen surgery |
author_facet |
Hamdy Ahmed Mostafa salama Salah Ayoub Soliman Ayman Fahmy Elramah |
author_sort |
Hamdy Ahmed Mostafa salama |
title |
Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Upper Abdominal Surgery |
title_short |
Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Upper Abdominal Surgery |
title_full |
Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Upper Abdominal Surgery |
title_fullStr |
Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Upper Abdominal Surgery |
title_full_unstemmed |
Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Upper Abdominal Surgery |
title_sort |
feasibility of laparoscopic cholecystectomy in patients with previous upper abdominal surgery |
publisher |
Egyptian knowledge bank |
series |
International Journal of Medical Arts |
issn |
2636-4174 2682-3780 |
publishDate |
2021-04-01 |
description |
Background: Previous abdominal surgery usually lead to adhesion formation, which considered as a contraindication of laparoscopic cholecystectomy (LC). However, it had been reported that, careful adhesiolysis could be performed and thus LC becomes feasible. Aim of the work: To assess the feasibility and outcome of laparoscopic cholecystectomy in patients with previous upper abdominal surgery. Patients and Methods: This study included 30 patients, who were presented by symptomatic gallstones. All participants assessed clinically. Then, a full lab profile was performed. Finally, abdominal ultrasound was done and if there was a dilatation of common bile duct, patients were submitted to magnetic resonance cholangiopancreatography. Both intra-and postoperative data were collected and any complications were documented.Results: 26 patients (86.7%) had chronic calcular cholecystitis, two had acute calcular cholecystitis and two had mucocele of gallbladder. Adhesions were grade 1 in 13.3%, grade 2 in 46.7%, grade 3 in 20% and grade 4 in 20.0%. Adhesiolysis was needed in twenty patients (66.7%). Intraoperative complications were reported in nine patients (40%). Bleeding reported in six patients and preformation of the gall bladder in three patients (10%). Three patients (10%) were converted to open surgery. Postoperatively, 12 patients (26.7%) had complications [3, 1, 2, 1 and 5 for port site wound infection, bile leakage, bleeding, and chest infection respectively). Post operative pain was mild in half of patients and moderate in other half. Conclusion: laparoscopic cholecystectomy after previous abdominal operations is relatively feasible and relatively safe, as nearly one third of patients had difficulties and complications. |
topic |
laparoscopic cholecystectomy adhesions feasibility upper abdomen surgery |
url |
https://ijma.journals.ekb.eg/article_159220_228ef77a6f478eb79d03e389db7f8b60.pdf |
work_keys_str_mv |
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