Laparoscopic cholecystectomy in patients with previous upper midline abdominal surgery: comparison of laparoscopic cholecystectomy after gastric surgery and non-gastric surgery using propensity score matching

Lee, Doo-Ho; Park, Yeon Ho; Kwon, O. Choel; Kim, Doojin

doi:10.1007/s00464-021-08427-9

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…A retrospective study enrolled 2235 patients and revealed that patients with a previous gastrectomy history were associated with a higher conversion rate while undergoing LC surgery [ 18 ]. Some other research also found similar result [ 16 , 17 , 19 ]. However, Sasaki et al [ 21 ] reported that there was no significant difference between the patients with and without previous gastrectomy in conversion rate.…”

Section: Discussionsupporting

confidence: 81%

“…The same conclusion was also found by Zhang et al [ 20 ]. As for the postoperative hospital stays, Sasaki et al [ 19 ] and Zhang et al [ 20 ] claimed that patients with a previous gastrectomy history didn’t prolong their postoperative hospital stays, which was opposite of other research [ 16 – 18 , 24 ]. One of the most usual reasons for converting from LC to OC was that the previous gastrectomy history might lead to adhesions [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 92%

“…Then, the titles and abstracts of the 429 studies were screened, and 21 studies were left for full-text screening. After the full-text screening, seven studies [ 16 – 21 , 24 ] were identified for final analysis. No more eligible studies were found by reviewing the reference of the included seven studies.…”

Section: Resultsmentioning

confidence: 99%

“…There existed an argument about whether previous gastrectomy history affected the surgical events while patients undergoing LC. Some studies revealed that previous gastrectomy increased the conversion rate while undergoing LC [ 16 – 19 ]. However, others reported opposite [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

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Does previous gastrectomy history affect the surgical outcomes of laparoscopic cholecystectomy?

Shu,

Wen,

2023

BMC Surg

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Purpose This current study aimed to explore whether gastrectomy history influenced surgical outcomes while undergoing laparoscopic cholecystectomy (LC). Methods The PubMed, Embase, and Cochrane Library databases were searched for eligible studies from inception to April 29, 2023. The Newcastle–Ottawa Scale (NOS) was adopted to assess the quality of included studies. The mean differences (MDs) and 95% confidence intervals (CIs) were calculated for continuous variables, and the odds ratios (ORs) and 95% CIs were calculated for dichotomous variables. RevMan 5.4 was used for data analysis. Results Seven studies enrolling 8193 patients were eligible for the final pooling up analysis (380 patients in the previous gastrectomy group and 7813 patients in the non-gastrectomy group). The patients in the gastrectomy group were older (MD = 11.11, 95%CI = 7.80–14.41, P < 0.01) and had a higher portion of males (OR = 3.74, 95%CI = 2.92–4.79, P < 0.01) than patients in the non-gastrectomy group patients. Moreover, the gastrectomy group had longer LC operation time (MD = 34.17, 95%CI = 25.20–43.14, P < 0.01), a higher conversion rate (OR = 6.74, 95%CI = 2.17–20.26, P = 0.01), more intraoperative blood loss (OR = 1.96, 95%CI = 0.59–3.32, P < 0.01) and longer postoperative hospital stays (MD = 1.07, 95%CI = 0.38–1.76, P < 0.01) than the non-gastrectomy group. Conclusion Patients with a previous gastrectomy history had longer operation time, a higher conversion rate, more intraoperative blood loss, and longer postoperative hospital stays than patients without while undergoing LC. Surgeons should pay more attention to these patients and make prudent decisions to avoid worse surgical outcomes as much as possible.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Does previous gastrectomy history affect the surgical outcomes of laparoscopic cholecystectomy?

Shu,

Wen,

2023

BMC Surg

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“…Likewise, during surgical interventions, unexpected situations may arise that delay their resolution and encourage modifying the surgical procedure initially established, which, added to the physical, psychological, and demographic characteristics of the users, determine the post-surgery process. Aspects that have a considerable impact on rehabilitation time and patient survival, (6,(22)(23)(24) more so when the nursing resource is scarce or when the care needs exceed their working hours. (4) Situations that must be addressed by those responsible of the health sector for better management of the nursing resource and of their clinical practice, which will contribute to increased patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Degree of Dependency and Hospitalization Time of Surgical Patients

Alarcón¹,

Cieza²

2023

Invest. Educ. Enferm.

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Objective. This work sought to establish the relationship between the degree of dependency with hospitalization time of patients intervened surgically in a regional hospital of Peru. Methods. The study was analytical, cross-sectional with retrospective data collection, studying 380 patients treated in the surgical service at Regional hospital Docente in the municipality of Cajamarca (Peru). The patients’ demographic and clinical information was obtained from the daily care records in the hospital’s surgery service. The univariate description was conducted through absolute and relative frequencies and confidence intervals for proportions at 95%; for the association between the degree of dependency and hospitalization time Log Rank (Mantel-Cox) – Chi-square was applied, as well as the Kaplan-Meier survival analysis, with statistical significance of p<0.05. Results. The study had 53.4% male patients, with mean age of 35.3 years, referrals from operating room (64.7%), surgery specialty (66.6%) and the most-frequent surgical intervention was appendectomy (49.7%). Mean hospitalization time was 10 days; 88.1% of the patients had grade-II dependency. The degree of patient dependency had a significant impact on the days of post-surgery hospitalization with direct relationship between both variables (p=0.038). Conclusion. Hospitalization time is determined by the degree of dependency of patients subjected to a surgical intervention; thereby, it is fundamental to anticipate all the necessary resources for proper care management.

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The effects of previous abdominal surgery and the utilisation of modified access techniques on the operative difficulty and outcomes of laparoscopic cholecystectomy and bile duct exploration

Lucocq,

Nassar

2024

Surg Endosc

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Background Early reports suggested that previous abdominal surgery was a relative contraindication to laparoscopic cholecystectomy (LC) on account of difficulty and potential access complications. This study analyses different types/systems of previous surgery and locations of scars and how they affect access difficulties. As modified access techniques to minimise risk of complications are under-reported the study details and evaluates them. Method Prospectively collected data from consecutive LC and common bile duct explorations (LCBDE) performed by a single surgeon over 30 years was analysed. Previous abdominal surgery was documented and peri-operative outcomes were compared with patients who had no previous surgery using Chi-squared analysis. Results Of 5916 LC and LCBDE, 1846 patients (31.2%) had previous abdominal surgery. The median age was 60 years. Those with previous surgery required more frequent duodenal (RR 1.07; p = 0.023), hepatic flexure (RR 1.11; p = 0.043) and distal adhesiolysis (RR 3.57; p < 0.001) and had more access related bowel injuries (0.4% vs. 0.0%; p < 0.001). Previous upper gastrointestinal and biliary surgery had the highest rates of adhesiolysis (76.3%), difficult cystic pedicles (58.8%), fundus-first approach (7.2%), difficulty grades (64.9% Grades 3–5) and utilisation of abdominal drains (71.1%). Previous open surgery resulted in longer operative time compared to previous laparoscopic procedures (65vs.55 min; p < 0.001), increased difficulty of pedicle dissection (42.4% vs. 36.0%; p < 0.05) and required more duodenal, hepatic flexure and distant adhesiolysis (p < 0.05) and fundus-first dissection (4% vs 2%; p < 0.05). Epigastric and supraumbilical access and access through umbilical and other hernias were used in 163 patients (8.8%) with no bowel complications. Conclusion The risks of access and adhesiolysis in patients with previous abdominal scars undergoing biliary surgery are dependent on the nature of previous surgery. Previous open, upper gastrointestinal and biliary surgery carried the most significant risks. Modified access techniques can be adopted to safely mitigate these risks. Graphical abstract

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Laparoscopic cholecystectomy in patients with previous upper midline abdominal surgery: comparison of laparoscopic cholecystectomy after gastric surgery and non-gastric surgery using propensity score matching

Cited by 6 publications

References 14 publications

Does previous gastrectomy history affect the surgical outcomes of laparoscopic cholecystectomy?

Does previous gastrectomy history affect the surgical outcomes of laparoscopic cholecystectomy?

Relationship between Degree of Dependency and Hospitalization Time of Surgical Patients

The effects of previous abdominal surgery and the utilisation of modified access techniques on the operative difficulty and outcomes of laparoscopic cholecystectomy and bile duct exploration

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