Laparoscopic cholecystectomy in patients with a history of gastrectomy

Sasaki, Akira; Nakajima, Jun; Nitta, Hiroyuki; Obuchi, Toru; Baba, Shigeaki; Wakabayashi, Go

doi:10.1007/s00595-007-3726-y

Cited by 37 publications

(41 citation statements)

References 10 publications

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“…Therefore, if cholecystectomy is performed by a skilled surgeon, the procedure can be carried out safely in patients with a history of gastric cancer operation. 5,6 Furthermore, in the present study, the open conversion among 45 patients with UAS history occurred in only 2 cases (4.4%), which is comparable to other studies. 5,6 In the present study, there were no significant differences in hospital stay or complication incidence between the UAS and non-UAS groups.…”

Section: Discussionsupporting

confidence: 78%

“…3 However, as this field has continued to advance, there have been reports suggesting that LC can be safely performed even in patients who underwent prior UAS. [4][5][6] Past studies have encouraged authors to perform LC in most patients who underwent prior UAS. Past studies have demonstrated the safety of LC in patients who underwent prior UAS, and this approach is generally used in patients with a UAS history.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Cholecystectomy after Upper Abdominal Surgery : Is It Feasible Even after Gastrectomy?

Lee

Jeong

Doojin

et al. 2017

J Minim Invasive Surg

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Purpose: Laparoscopic cholecystectomy (LC) is now a standard operation for benign gallbladder (GB) disease. However, previous upper abdominal surgery (UAS) has been regarded as a relative contraindication for LC. The purpose of this study was to examine the effects of history of upper abdominal surgery including gastrectomy on the operative and postoperative results of LC. Methods:A total of 769 patients underwent LC between March 2008 and December 2015, and the surgical outcomes of 45 patients who had a history of UAS were retrospectively compared with those who did not. Twenty of 45 patients with a history of UAS received gastrectomy, and the remaining 25 received non-gastrectomy UAS. The degree of adhesion and clinical outcomes were further compared between these two groups. Results:The patients with a history of UAS required placement of a greater number of trocars, longer operation time, longer duration of drainage insertion, and higher open conversion rate (4.4%) compared to patients with no history of UAS. However, there were no significant differences in postoperative hospital stay or complication rate between the two groups. In the UAS group, 93.3% of patients required adhesiolysis. There were no significant differences in clinical findings or perioperative outcomes between gastrectomy group and non-gastrectomy group. Conclusion: A history of UAS including gastrectomy increases the technical difficulty of LC as wellas open conversion rate. However, LC can be a feasible and safe approach when performed with adequate methods.

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Laparoscopic Cholecystectomy after Upper Abdominal Surgery : Is It Feasible Even after Gastrectomy?

Lee

Jeong

Doojin

et al. 2017

J Minim Invasive Surg

View full text Add to dashboard Cite

show abstract

“…Some authors advocated prophylactic cholecystectomy, simultaneous removal of the gallbladder during gastric resection to prevent potential gallstone-related sequelae, such as cholecystitis, cholangitis, and pancreatitis [8]. This approach also avoided the possibility of subsequent cholecystectomy, which might be difficult owing to potential adhesion at the upper abdomen caused by previous gastrectomy and lymph node dissection [9]. A multicenter, randomized controlled trial, the Cholegas study, was initiated in November 2008 to evaluate prophylactic cholecystectomy; however, the final result has not been disclosed yet [10].…”

Section: Introductionmentioning

confidence: 99%

Analysis of gallstone disease after gastric cancer surgery

et al. 2017

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Background The incidence rate of newly developed gallstone disease after gastrectomy for gastric cancer is thought to be higher than that in the general population. However, the presentation and management of these gallstones remain under debate, and the role of prophylactic cholecystectomy remains questionable. Methods Data on adult patients who were diagnosed with gastric cancer and received gastrectomy between 2000 and 2011 were extracted from the Taiwan National Health Insurance Research Database. A patient was excluded if he or she had gallstone disease or received cholecystectomy before the index date. The incidence of newly developed gallstone disease and its subsequent management were recorded. Data were analyzed to evaluate the factors associated with gallstone development and treatment options. Results A total of 17,325 gastric cancer patients who underwent gastrectomy were eligible for analysis. During the follow-up period (mean 4.1 years; median, 2.9 years), 1280 (7.4%) patients developed gallstone disease and 560 (3.2%) patients subsequently underwent cholecystectomy. The in-hospital mortality for cholecystectomy was 1.8% (10/560). Development of gallstone disease was associated with older age, total gastrectomy, duodenal exclusion, diabetes, cirrhosis, and more comorbidities. Factors associated with the use of cholecystectomy to treat gallstone disease included younger age, fewer comorbidities, medical center admission, and presentation as cholecystitis. Conclusions Although few patients required further gallbladder removal after gastrectomy for gastric malignancy, the increased mortality rate for subsequent cholecystectomy was worth noting. The decision to undergo prophylactic cholecystectomy might be individualized based upon patient characteristics and the surgeon's discretion.

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“…Due to such higher rate of gallstones, some Authors proposed prophylactic cholecystectomy, advocating that concomitant cholecystectomy is not time consuming and substantially with minimal additional risks for the patients [14][15][16], while subsequent cholecystectomy (in most cases attempted laparoscopically) is known to be more challenging after gastric surgery, with an increased risk of conversion, bile duct injuries and a longer operating time [17,18]. Another advantage of prophylactic cholecystectomy was represented by the avoidance of a possible reintervention in case of acute post-operative cholecystitis [7,19,20] and the avoidance of difficult procedures like endoscopic retrograde cholangiography (ERC) in the presence of Roux-en-Y reconstruction.…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, not all the patients who are diagnosed to have cholelithiasis after gastric cancer surgery will develop symptoms or require additional surgical treatments [2][3][4] and a standard laparoscopic cholecystectomy is feasible even in those patients who underwent previous gastric surgery [17,21]. Moreover, in recent years, the problem of litigation and malpractice claims have raised the issue of removing a normal organ for prophylaxis of any benign disease.…”

Section: Introductionmentioning

confidence: 99%

The Cholegas Study: safety of prophylactic cholecystectomy during gastrectomy for cancer: preliminary results of a multicentric randomized clinical trial

et al. 2012

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Background Cholelithiasis is more frequent in patients after gastrectomy, due to dissection of vagal branches and gastrointestinal reconstruction. Methods A randomized controlled trial was conducted from November 2008 to March 2012. Patients were randomized into two groups: prophylactic cholecystectomy (PC) and standard gastric surgery only (SS) for curable cancers. We planned three end points: evaluation of the number of patients who developed symptoms and needed further surgery for cholelithiasis after standard gastric cancer surgery, evaluation of the incidence of cholelithiasis overall after standard gastric cancer surgery and perioperative complications or costs of prophylactic cholecystectomy. The present study answers to the last end point only.

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Laparoscopic cholecystectomy in patients with a history of gastrectomy

Abstract: Laparoscopic cholecystectomy is a safe and effective treatment for symptomatic gallstone disease in patients with a history of gastrectomy, although previous gastrectomy is associated with an increased need for adhesiolysis and a longer operative time.

Cited by 37 publications

References 10 publications

Laparoscopic Cholecystectomy after Upper Abdominal Surgery : Is It Feasible Even after Gastrectomy?

Laparoscopic Cholecystectomy after Upper Abdominal Surgery : Is It Feasible Even after Gastrectomy?

Analysis of gallstone disease after gastric cancer surgery

The Cholegas Study: safety of prophylactic cholecystectomy during gastrectomy for cancer: preliminary results of a multicentric randomized clinical trial

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