J Minim Invasive Surg.  2017 Mar;20(1):22-28. 10.7602/jmis.2017.20.1.22.

Laparoscopic Cholecystectomy after Upper Abdominal Surgery : Is It Feasible Even after Gastrectomy?

  • 1Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. drkdj@hallym.or.kr


Laparoscopic cholecystectomy (LC) is now a standard operation for benign gallbladder (GB) disease. However, previous upper abdominal surgery (UAS) has been regarded as a relative contraindication for LC. The purpose of this study was to examine the effects of history of upper abdominal surgery including gastrectomy on the operative and postoperative results of LC.
A total of 769 patients underwent LC between March 2008 and December 2015, and the surgical outcomes of 45 patients who had a history of UAS were retrospectively compared with those who did not. Twenty of 45 patients with a history of UAS received gastrectomy, and the remaining 25 received non-gastrectomy UAS. The degree of adhesion and clinical outcomes were further compared between these two groups.
The patients with a history of UAS required placement of a greater number of trocars, longer operation time, longer duration of drainage insertion, and higher open conversion rate (4.4%) compared to patients with no history of UAS. However, there were no significant differences in postoperative hospital stay or complication rate between the two groups. In the UAS group, 93.3% of patients required adhesiolysis. There were no significant differences in clinical findings or perioperative outcomes between gastrectomy group and non-gastrectomy group.
A history of UAS including gastrectomy increases the technical difficulty of LC as well as open conversion rate. However, LC can be a feasible and safe approach when performed with adequate methods.


Laparoscopic cholecystectomy; Gastrectomy; Adhesion; Conversion to open sugery

MeSH Terms

Cholecystectomy, Laparoscopic*
Length of Stay
Retrospective Studies
Surgical Instruments
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