title: Laparoscopic cholecystectomy in patients with a previous history of gastrectomy.
abstract: OBJECTIVE
  Laparoscopic cholecystectomy (LC) in patients with a previous history of upper abdominal surgery is a difficult procedure with a high conversion rate.
  
  
  METHODS
  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.
authors.affiliation: Department of Surgery, Tohkai Hospital, Nagoya, Japan. hide@qj8.so-net.ne.jp
authors.forename: Hideo
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Naokazu
authors.initials: N
authors.lastname: Hayakawa
authors.forename: Tatuyoshi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Masato
authors.initials: M
authors.lastname: Momiyama
authors.forename: Masato
authors.initials: M
authors.lastname: Nagino
mesh_terms: D016009:Chi-Square Distribution; D017081:Cholecystectomy, Laparoscopic / Q000401:mortality; D000075202:Contraindications; D005743:Gastrectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007902:Length of Stay; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012307:Risk Factors; D013997:Time Factors; D000267:Tissue Adhesions; D016896:Treatment Outcome