Is laparoscopic cholecystectomy a mature operative technique?

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.

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“…The operative technique was completed as described by Welty et al [9] . Briefly, patients instructed for 6 hours fasting before operation.…”

Section: Methodsmentioning

confidence: 99%

Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Upper Abdominal Surgery

Salama

Soliman

Elramah

2021

International Journal of Medical Arts

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“…Laparoscopic Cholecystectomy (LC) is one of the most commonly performed abdominal surgical procedures [1,2] and has been considered as a standard surgical treatment for gallstone diseases including cholelithiasis, acalculous cholecystitis, gallbladder polyp, and porcelain gallbladder [3,4] . The procedure itself was a mature operative technique [5] , which usually can be performed under general anesthesia within a short duration of time. Along with that healthy and reliable patients with good home support can leave the hospital shortly after the surgery [6,7] .…”

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confidence: 99%

Combined Therapeutic Value of Acupuncture and Parecoxib Sodium Therapy for Bowel Function Recovery after Laparoscopic Cholecystectomy

Xiao,

Xiao

2024

IJPS

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The main objective of this study is to investigate the added therapeutic value of acupuncture+parecoxib sodium therapy on bowel function recovery after laparoscopic cholecystectomy. According to the calendar periods of the hospital admission, we retrospectively included 173 patients who received laparoscopic cholecystectomy, some of whom received acupuncture at Zusanli, Yanglingquan, and Taichong combined with parecoxib sodium therapy. Of the 173 patients included, 53 (30.6 %) received postoperative acupuncture plus parecoxib sodium therapy. There was no statistically significant difference in baseline characteristics of the patients (p>0.05). Gastrointestinal symptoms and time taken for first anal exhaust or first defecation after the surgery were studied as outcomes to evaluate the recovery of bowel function. Patients who received acupuncture plus parecoxib sodium therapy experienced fewer gastrointestinal symptoms including bloating (11.3 % vs. 25.8 %, p=0.032) and constipation (13.2 % vs. 27.5 %, p=0.040), a shorter time to first anal exhaust (37.7±11.3 h vs. 44.2±14.6 h, p=0.005) and time to first defecation (60.3±18.7 h vs. 68.4±21.1 h, p=0.017), and fewer prescriptions of gastric prokinetic agents (28.3 % vs. 45.8 %, p=0.030) compared to those patients, who did not receive any acupuncture treatment (parecoxib sodium monotherapy). In addition to standard care, acupuncture at Zusanli, Yanglingquan, and Taichong+parecoxib sodium therapy facilitates the recovery of bowel function after laparoscopic cholecystectomy.

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“…These include deliberate exposure of the Calot's triangle [2], establishment of the ''critical view'' [3], and use of the ''top-down'' (retrograde dissection) technique [4]. Little beyond description and speculation, however, has been published about the surgeon's standing position or use of the one-versus two-handed technique [5][6][7][8], and currently there are no agreed-upon recommendations in terms of how these two primary elements affect LC performance [9].…”

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confidence: 99%

Laparoscopic cholecystectomy poses physical injury risk to surgeons: analysis of hand technique and standing position

et al. 2011

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Laparoscopic cholecystectomy poses a risk of physical injury to the surgeon. As LC is currently commonly performed in the United States, the left side-standing position may lead to increased physical demand and effort, resulting in ergonomically unsound conditions for the surgeon. Though further investigations should be conducted, adopting the between-standing position deserves serious consideration as it may be the best short-term ergonomic alternative.

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Is laparoscopic cholecystectomy a mature operative technique?

Cited by 8 publications

References 7 publications

Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Upper Abdominal Surgery

Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Upper Abdominal Surgery

Combined Therapeutic Value of Acupuncture and Parecoxib Sodium Therapy for Bowel Function Recovery after Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy poses physical injury risk to surgeons: analysis of hand technique and standing position

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