Safety of laparoscopic cholecystectomy among patients with previous upper abdominal surgery

Background- Aim: Laparoscopic cholecystectomy has been considered as the procedure of choice for symptomatic cholelithiasis. Previous abdominal surgery is clarified to have a high rate of conversion and attributed to dense adhesion. So, the present investigation was directed to estimate the probability and safety of the laparoscopic cholecystectomy among the patients who had previous upper abdominal surgery. Methods: A prospective clinical trial was carried on 48 patients presented with symptomatic gallstone disease with history of previous upper abdominal surgery underwent laparoscopic cholecystectomy. The current study was carried out in the department of General Surgery, Zagazig University Hospitals, Egypt through the interval from February 2019 to February 2020. Results: The mean age of the studied patients was 47.78±11.68 years. Most of them presented with biliary colic (81.25%) and the mean operative time was 144.22±9.5 minutes. Three cases were converted to open with (6.25%) conversion rate. The mean hospital stay was 2.8±1.1 days. The morbidity rate was (4.16%) in the form of wound infection in three cases, bile leakage from cystic duct in one case, paralytic ileus in two cases, and umbilical hernia in two cases. No cases were clarified with a bile duct injury or postoperative bleeding and there was no blood transfusion required. No mortality was reported. Conclusions: Laparoscopic cholecystectomy is a feasible and safe treatment for the symptomatic gallstone disease in the selected patients with previous upper abdominal surgery. However, appropriate preoperative preparations, patients' assessment, careful intraoperative techniques, and well-experienced surgeon are mandatory for good outcomes.