Abstract

Background: Laparoscopic cholecystectomy (L.C.) is gold standard surgery for gallstones. Their are risks have some surgeons from the laparoscopic procedure in patients with history of abdominal surgery. We aimed to investigate the effect of laparoscopic cholecystectomy by previous abdominal surgery. Methods: This study included 110 patients with gallstones who underwent laparoscopic cholecystectomy at our surgical department between August 2012 and July 2014. The patients were classified into groups: group 1, patients with a history of upper abdominal surgery (n=13); group 2, patients with a history of lower abdominal surgery (n=97). The data were collected and analyzed for adhesion found, adhesiolysis required, visceral organ injury, open conversion rates, operative times and hospital stay. Results: 110 had undergone previous abdominal surgery (13 upper, 97 lower). Adhesiolysis required in 12 (n=13) patients in group 1 and 15 (n=97) patients in group 2. Visceral injury were more in group 1 .Conversion rate was higher in group 1 than group 2 due to difficulty in accessibility of gallbladder as adhesions were there. Our mean operative time was 37.4+/_ 7.2 min in group 2 and 76.9+/_ 16.1 min in group 1. Post operative hospital stay was increased in upper abdominal surgery. Conclusion: Gallbladder accessibility is important for feasibility of L.C. Previous upper abdominal surgery is associated with adhesions in and around the feild of work increased need for adhesiolysis, a higher open conversion rate, a prolonged operating time and a longer postoperative stay and risk of injuries to adjacent structures.