title: Conversion in laparoscopic cholecystectomy after gastric resection: a 15-year review.
abstract: BACKGROUND
  Gastrectomy or truncal vagotomy is known to increase the incidence of cholelithiasis. Many of these patients will become symptomatic, and the adhesions from their gastric resection may make laparoscopic cholecystectomy much more difficult.
  
  
  METHODS
  We prospectively assessed the data for the 15-year cumulative laparoscopic cholecystectomy experience of 1 surgeon at a university teaching hospital with respect to conversion and postoperative outcomes, with particular attention to patients having had previous gastric resections.
  
  
  RESULTS
  Patients with previous gastrectomies had similar operative times (mean 81.1, range 45-120 min), a higher conversion rate (64.2%) and a higher complication rate (35.7%) than those who had had other previous upper abdominal surgeries (mean 73.2, range 35-130 min, conversion 25% and complication 11.3%) and those without previous abdominal surgeries (mean 66.5, range 25-250 min, conversion 2.7% and complication 4.5%).
  
  
  CONCLUSIONS
  Preoperative knowledge of the increased conversion rate and increased morbidity will inform surgical planning for both the surgeon and the patient.
authors.affiliation: Department of Surgery, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montréal, Que. sfraser@surg.jgh.mcgill.ca
authors.forename: Shannon A
authors.initials: SA
authors.lastname: Fraser
authors.forename: Harvey
authors.initials: H
authors.lastname: Sigman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000209:etiology / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000267:Tissue Adhesions / Q000209:etiology; D055815:Young Adult