A STUDY OF LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH PREVIOUS ABDOMINAL SURGERY
Abstract
Introduction: Patients with previous abdominal surgery were earlier recommended not to undergo laparoscopy because of the increased risk of penetrating bowel injury. Keeping the above factors in mind the present study was undertaken and conducted in Surgery Department of Government Medical College and Rajindra Hospital, Patiala (Punjab) to study the procedure in patients with previous abdominal surgery and evaluate its outcome.
Material and Methods: This prospective, parallel-group study was conducted in the Department of General Surgery after approval from the Institutional Ethics Committee. Patients of symptomatic gallstones willing to give written informed consent were enrolled in the study, documented by ultrasonography between the age group of 18 to 70 years and willing to give written informed consent for laparoscopic cholecystectomy were included in the study. Patients have divided into two groups: Group A had patients who had no history of previous abdominal surgery and Group B had patients who had previously undergone abdominal surgery.
Results: A total of 255 patients with symptomatic gallstones were screened for the study and 195 patients completed the entire study (97 patients in Group A and 98 patients in Group B). Patients who had undergone a previous abdominal surgery had significantly higher adhesion, more conversion to open surgery, a greater duration of surgery and greater post-operative pain as compared to patients who had no previous abdominal surgery when they underwent laparoscopic cholecystectomy.
Conclusion: Previous abdominal surgery does not represent a contraindication for laparoscopic cholecystectomy and patients following previous abdominal surgery although they have a longer duration of stay as compared to patients with no previous abdominal surgery.
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References
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