Katar Mehmet Kağan, Ersoy Pamir Eren
General Surgery, Yozgat Bozok University Faculty of Medicine, Yozgat, TUR.
Cureus. 2021 Apr 3;13(4):e14272. doi: 10.7759/cureus.14272.
Background and objective In this era of minimally invasive surgery and enhanced recovery procedures, laparoscopic cholecystectomy (LC) is the prevailing treatment method for symptomatic cholelithiasis. However, there are some contraindications for this operation, such as a previous upper abdominal surgery. Additionally, the median conversion rate of LC is 5%. In this study, we aimed to investigate the effect of previous upper abdominal surgery on LC. Methods The study was designed as a single-center, retrospective, and observational analysis. A total of 277 LC patients were evaluated by classifying them into two groups - group A: those without previous upper abdominal surgery; group B: those with a history of previous upper abdominal surgery. Results Not surprisingly, the operation time and the degree of adhesions in group B were significantly higher compared to group A (p<0.001). On the other hand, there were no significant differences between the two groups in terms of complication rates, conversion rates, and the length of hospital stay (p=0.118, p=0.761, p=0.083, respectively). Conclusion LC is a safe method for cholelithiasis even in patients with a history of upper abdominal surgery. Previous upper abdominal surgery does not affect the conversion rates and length of hospital stay. Hence, previous upper abdominal surgery should not be accepted as a contraindication for LC.
背景与目的 在这个微创手术和加速康复程序的时代，腹腔镜胆囊切除术（LC）是有症状胆结石的主要治疗方法。然而，该手术存在一些禁忌症，如既往上腹部手术史。此外，LC的中位中转率为5%。在本研究中，我们旨在探讨既往上腹部手术对LC的影响。方法 本研究设计为单中心、回顾性观察分析。将277例LC患者分为两组进行评估——A组：无既往上腹部手术史者；B组：有既往上腹部手术史者。结果 不出所料，B组的手术时间和粘连程度显著高于A组（p<0.001）。另一方面，两组在并发症发生率、中转率和住院时间方面无显著差异（分别为p=0.118、p=0.761、p=0.083）。结论 即使是有上腹部手术史的患者，LC也是治疗胆结石的安全方法。既往上腹部手术不影响中转率和住院时间。因此，既往上腹部手术不应被视为LC的禁忌症。
