Amal A Hunjur
Taif University, KSA
Title: Laparoscopic cholecystectomy for acute cholecystitis with previous abdominal surgery
Biography
Biography: Amal A Hunjur
Abstract
Introduction & Aim: The aim of this study was to find out if laparoscopic cholecystectomy for acute cholecystitis is also an adequate surgical procedure in patients with a status post previous abdominal surgeries.
Material & Methods: Between 1.4.2010 till 31.8.2013, 858 patients underwent surgery for chronic cholecystitis (n=595) or acute cholecystitis (n=245). 788 of the patients had their surgeries done minimal invasively. 56 of the patients had a history of a previous abdominal surgery. 32% of all previous surgeries were upper abdominal and 68% lower abdominal. All patients with a history of lower abdominal laparotomy had their camera trocar supraumbilically introduced, whereas in patients with previous upper abdominal surgeries the location of the camera trocar was variable and a function of the previous abdominal incision. The introduction of the other trocar ports was after careful adhesiolysis under optical vision in the usual abdominal wall locations.
Results: A laparoscopic cholecystectomy was possible in all 245 acute cholecystitis patients. The conversion rate in acute cholecystitis after previous abdominal surgery (n= 18) was 5.5% and the median duration of surgery was 95 minutes (69 to 235 minutes). The median hospital stay was 8 days (4 – 18 days) which was not much longer than in laparoscopic cholecystectomy in patients no previous abdominal surgeries.
Conclusion: Laparoscopic cholecystectomy for acute cholecystitis is also an adequate procedure in patients with a history of previous abdominal surgeries associated with low rate of complication.