Laparoscopic cholecystectomy in patients with a previous history of gastrectomy.

Abstract Background/Aims:Laparoscopic cholecystectomy (LC) in patients with a previous history of upper abdominal surgery isa difficult procedure with a high conversion rate. Methodology: Forty-two patients with a previous history of gastrectomy (gastrectomy group) were compared to patients without previous abdominal surgery (no surgery group, n=1375). Patients in the gastrectomy group were divided into two groups for comparison: first, an umbilicus-group (n=12, at the umbilicus) and a side-group (n=23, right of the umbilicus) by the location of the primary port insertion, second, a benign group (n=31) and a malignant group (n=11). Results: Patients in the gastrectomy group had similar operative morbidity but a significantly higher conversion rate and a longer postoperative hospital stay than patients in the no-surgery group. Conversion was performed in four patients in the gastrectomy group (9.5%): 3 in the umbilicus-group and one in a side-group. Two patients in the umbilicus-group had adhesion only just around the primary port site. Patients in the malignant group had similar postoperative hospital stay and morbidity but a significantly longer operating time than patients in the benign group. Conclusions: Previous gastrectomy for benign or malignant diseases is no longer considered a relative contraindication for performance of safe LC.