title: Difficult abdominal access in laparoscopic cholecystectomy in elderly patients: our experience and literature review.
abstract: Laparoscopic cholecystectomy (LC) is currently the gold standard treatment for symptomatic cholelithiasis. LC is actually condidered a medium complexity surgical operation. LC could be technically hard, especially if patient underwent previous surgical operation. These difficulties increase in outcome of previous operation in right upper quadrant (RUQ): in this case laparoscopic access is defined as an "hard access". We present two cases in which an unconventional access was performed: laparoscopic cholecistectomy is a safe and feasible procedure, although a careful assessment preoperative is indispensable. In particular, caution is required in both the triangulation of the trocar, which in pneumoperitoneum induction.
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: alessandra.sur@gmail.com.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Surace
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: silvia.marola@gmail.com.
authors.forename: Silvia
authors.initials: S
authors.lastname: Marola
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: ros.ben@libero.it.
authors.forename: Rosa
authors.initials: R
authors.lastname: Benvenga
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: alexbori@libero.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Borello
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: valentina.gentile87@gmail.com.
authors.forename: Valentina
authors.initials: V
authors.lastname: Gentile
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: alessiaferrarese.md@gmail.com.
authors.forename: Alessia
authors.initials: A
authors.lastname: Ferrarese
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: stefano_e@libero.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Enrico
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: valtermartino.md@gmail.com.
authors.forename: Valter
authors.initials: V
authors.lastname: Martino
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: mario.nano@unito.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Nano
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: mariosolej@gmail.com.
authors.forename: Mario
authors.initials: M
authors.lastname: Solej
mesh_terms: D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery; D005774:Gastrostomy; D006801:Humans; D007081:Ileostomy; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications; D013525:Surgical Instruments
keywords: Ileostomy; Laparoscopic cholecystectomy; Percutaneous endoscopy gastroscopy