A comparative study of postoperative adhesion formation after laparoscopicvs open cholecystectomy

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.