Original Article
J Minim Invasive Surg 2009; 12(2): 108-112
Published online December 15, 2009
© The Korean Society of Endo-Laparoscopic & Robotic Surgery
상복부수술의 과거력이 있는 환자들에게 시행한 복강경 담낭절제술
배영식ㆍ이상목ㆍ김주현ㆍ김범수ㆍ주선형
경희대학교 의학전문대학원 외과학교실
Laparoscopic Cholecystectomy in Patients with a History of Upper Abdominal Surgery
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: Laparoscopic cholecystectomy is currently the treatment of choice for gallbladder disease. Previous abdominal surgery was considered as a relative contraindication for laparoscopic cholecystectomy due to the presence of intraabdominal adhesion and the difficulty in visualization. Several recent studies have suggested that previous abdominal surgery is no longer a contraindication for laparoscopic surgery by virtue of the accumulation of surgeons' experience and the evolution of laparoscopic instruments. In this study, we evaluated the impact of previous upper abdominal surgery on laparoscopic cholecystectomy.
Methods: The data of 706 consecutive patients who underwent laparoscopic cholecystectomy from September 2004 to December 2007 was retrospectively analyzed. Thirty-three patients had undergone pervious upper abdominal surgery and 673 patients had not. We compared the operative time, the type of trocar that was used, the postoperative complications, the frequency of open conversion and the length of the postoperative hospital stay between the two groups
Results: The operative time was longer (141.8±88.7 min vs. 74.1±37.4 min, p＜0.001) and larger trocars were used more often (p＜0.001) in the previous upper abdominal surgery group. There was no significant difference in the open conversion rate, the major postoperative complication rate and the length of the postoperative hospital stay.
Conclusion: Laparoscopic cholecystectomy might be an optimal treatment for patients with a history of previous upper abdominal surgery. Previous upper abdominal surgery is not a contraindication for laparoscopic cholecystectomy when it is performed by experienced laparoscopic surgeons.
Keywords 복강경 담낭절제술, 상복부수술 과거력
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Original Article
J Minim Invasive Surg 2009; 12(2): 108-112
Published online December 15, 2009
Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.
상복부수술의 과거력이 있는 환자들에게 시행한 복강경 담낭절제술
배영식ㆍ이상목ㆍ김주현ㆍ김범수ㆍ주선형
경희대학교 의학전문대학원 외과학교실
Laparoscopic Cholecystectomy in Patients with a History of Upper Abdominal Surgery
Young Sik Bae, M.D., Sang Mok Lee, M.D., Joo Hyun Kim, M.D., Bum Soo Kim, M.D., Sun Hyung Joo, M.D.
Department of Surgery, Kyung Hee University School of Medicine, Seoul, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Laparoscopic cholecystectomy is currently the treatment of choice for gallbladder disease. Previous abdominal surgery was considered as a relative contraindication for laparoscopic cholecystectomy due to the presence of intraabdominal adhesion and the difficulty in visualization. Several recent studies have suggested that previous abdominal surgery is no longer a contraindication for laparoscopic surgery by virtue of the accumulation of surgeons' experience and the evolution of laparoscopic instruments. In this study, we evaluated the impact of previous upper abdominal surgery on laparoscopic cholecystectomy.
Methods: The data of 706 consecutive patients who underwent laparoscopic cholecystectomy from September 2004 to December 2007 was retrospectively analyzed. Thirty-three patients had undergone pervious upper abdominal surgery and 673 patients had not. We compared the operative time, the type of trocar that was used, the postoperative complications, the frequency of open conversion and the length of the postoperative hospital stay between the two groups
Results: The operative time was longer (141.8±88.7 min vs. 74.1±37.4 min, p＜0.001) and larger trocars were used more often (p＜0.001) in the previous upper abdominal surgery group. There was no significant difference in the open conversion rate, the major postoperative complication rate and the length of the postoperative hospital stay.
Conclusion: Laparoscopic cholecystectomy might be an optimal treatment for patients with a history of previous upper abdominal surgery. Previous upper abdominal surgery is not a contraindication for laparoscopic cholecystectomy when it is performed by experienced laparoscopic surgeons.
Keywords: 복강경 담낭절제술, 상복부수술 과거력
