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 rupture 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 feasible and relatively safe, as minority of patients had difficulties and complications.