Surgical Outcome of Laparoscopic Cholecystectomy in Patients With a History of Gastrectomy

Abstract

Background: Although laparoscopic cholecystectomy (LC) has been applied to patients with a history of abdominal surgery, we lack data on the surgical outcome of LC in patients with a history of gastrectomy. Here, we assessed the outcomes of LC and investigated predictive factors for conversion from laparoscopic to open surgery in patients with a gastrectomy history.Patients and Methods: We retrospectively compared the surgical outcomes of LC between patients with and without a history of gastrectomy. We performed multivariate regressions to identify independent predictive factors for open conversion during an LC.Results: Among 2235 patients who underwent LCs, 39 (1.7%) had undergone a previous gastrectomy (29 men, 10 women; mean age, 72 y; 34 with distal gastrectomy and 5 with total gastrectomy). The operation time, intraoperative bleeding, postoperative hospital stays, and conversion rate were significantly worse in patients with, compared with those without the history of gastrectomy. Conversion during an LC in the cases with a history of gastrectomy was significantly correlated with age and the type of gastrectomy.Conclusions: These results suggested that LC in patients with a history of gastrectomy exhibited worse outcomes in terms of operation time, intraoperative bleeding, postoperative hospital stay, and conversion rate than those without it. Furthermore, it was also implied that age and the type of gastrectomy were significant predictive factors for conversion during an LC in patients with a history of gastrectomy.

Clinical Characteristics of Symptomatic Cholecystitis in Post-Gastrectomy Patients: 11 Years of Experience in a Single Center

“…The proportion of patients who underwent gastrectomy among patients hospitalized in the ER for symptomatic cholecystitis was approximately 2.8%, which is similar to that reported in other studies [ 27 , 28 ]. It was determined that the gastrectomy did not affect the severity of inflammation or the pathology of the GB.…”

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

“…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 ].…”

“…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 ].…”

Drain fluid biomarkers for prediction and diagnosis of clinically relevant postoperative pancreatic fistula: A narrative review

“…Investigations in distal pancreatectomy cohorts: Similar to pancreatoduodenectomy studies, distal pancreatectomy patients with positive drain culture have been associated with significantly higher rates of CR-POPF[ 163 , 164 ] with positive drain culture being an independent risk factor for the complication before POD3[ 165 ] and on POD4[ 166 ]. However, abdominal infection was not found to be a risk factor for CR-POPF by Sato et al [ 167 ] in their cohort of 49 patients which may have been underpowered.…”

“…most frequently in the drain fluid of CR-POPF patients. Harino et al [ 163 ] found Staphylococcus numbers to increase in patients when drains were removed after POD5, with Yang’s group reporting rapid increases in positive drain culture when drains remained between POD3 and POD7 with a prevalence of 21.6% and 73.3% respectively[ 165 ]. Hence, earlier drain removal may assist in curbing the growth of bacteria and its subsequent role in CR-POPF development.…”