G. Polymeneas et al., A comparative study of postoperative adhesion formation after laparoscopicvs open cholecystectomy, SURG ENDOSC, 15(1), 2001, pp. 41-43
Citations number
18
Categorie Soggetti
Surgery
Journal title
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES
Background: There is little evidence in the literature to support a lower i
ncidence of adhesion formation following laparoscopic surgery rather than l
aparotomy. Adhesion formation after laparotomy has been well studied, but w
e believe that the decrease or absence of adhesions following laparoscopic
surgery is underreported. Therefore, we set out to evaluate adhesion format
ion following laparoscopic cholecystectomy (LC) compared with open cholecys
tectomy (OC).
Methods: Group A consisted of is patients who underwent a second laparoscop
y due to various intraabdominal diseases after an LC had already been perfo
rmed. Group B consisted of eight patients who underwent laparoscopy due to
various intraabdominal diseases after an open cholecystectomy performed at
an earlier date. In both groups, the frequency, extent, and thickness of ad
hesions were evaluated according to a standardized scoring system.
Results: Ten patients in group A (55.5%) had no adhesion formation either o
n the treated side of the previous LC or on the trocar entry sites. Three p
atients (16.6%) had minimal adhesions on the treated side of the previous L
C, but no adhesions were observed at the trocar entry sites. Five patients
(27.7%) had loose, easily separable adhesions on the treated site of the pr
evious LC and at the trocar entry sites. All eight patients in group B (100
%) had thick and extensive adhesions either on the treated side of the prev
ious open cholecystectomy or the anterior abdominal wall below the surgical
incision.
Conclusion: This comparative clinical study suggests that LC results in les
s adhesion formation, either on the operative or at the trocar entry sites,
than open cholecystectomy.