Postoperative Peritoneal Adhesion Syndrome - a Challenging Issue in Laparoscopic Surgery

Abstract

Introduction: The presence of the peritoneal adhesions during surgery represents an element that can negatively influence the intra- and postoperative evolution of the patients. This article aims to evaluate the impact of the peritoneal adhesions on the postoperative recovery of the patients. Material and method: The data of 1407 patients undergoing laparoscopic cholecystectomy between January 2014 and October 2018 were retrospectively analyzed. Patients were organized into two groups: the case group, consisting of patients for whom peritoneal adhesions were identifi ed during the surgical intervention, and the control group, with patients that had no postoperative peritoneal adhesions. The degree of association between the presence of the peritoneal adhesions and the operative time, the risk of laparoscopic conversion to laparotomy and the risk of intra- or postoperative complications was analyzed. Results: For 537 patients (38.16%) included in the study postoperative peritoneal adhesions were identifi ed at the time of the laparoscopic cholecystectomy. A direct association was observed between the presence of postoperative peritoneal adhesions and the risk of conversion, a longer operative time or period of hospitalization and the risk of postoperative ileus. Conclusions: Postoperative peritoneal adhesions represent an independent risk factor for the increasing morbidity and mortality rates in patients undergoing laparoscopic cholecystectomy.

Keywords

• laparoscopic cholecystectomy
• peritoneal adhesions
• burden
• postoperative recovery