LAPAROSCOPIC CHOLECYSTECTOMY IN PREVIOUSLY LAPAROTOMIZED PATIENTS

Abstract

In the years of it's initial clinical application, previous abdominal surgery was reported as a relative contraindication to laparoscopic Cholecystectomy.

Out of 420 patients having undergone laparoscopic cholecystectomy in our department, 42 (10%) had incisional scars confirming previous abdominal operations, 22 patients with preceeding periumbilical and upper abdominal operations were reoperated by open laparoscopy using the Hasson canula application.

The other 20 laparoscopic cholecystectomies were performed with the classical North American technique. Conversion to the open cholecystectomy was necessary only in one case also having acute cholecystitis (2.4%). In all other cases the operation was performed successfully (97.6%). No intraoperative complication was noted. One case showed local suppuration as a morbidity (2.4%). The mean operation time was 64.1 m/n. (range:30-120 mm.), the mean hospitalization period 2 days (range: 1-7 days), and the return to normal activity in 7 days (range: 4-14 days). In conclusion, after having gained adequate experience, and by using a meticulous technique, laparoscopic cholecystectomy can be performed successfully in previously laparatomized patients.