Laparoscopy After Liver Transplant: Result of an Initial Series

• Laparoscopic surgery has shown advantages in the recovery after surgery.
• In patients who underwent major surgery, adhesions could not create an adequate environment for laparoscopy.
• We present a series of cases about laparoscopy in patients who had previously received a liver transplant.
• The laparoscopic procedures are divided between those of the upper and lower abdomen, and also concerning about how long after the liver transplant the procedure was performed.
• The procedure was feasible and effective; there were no conversions in our series.

There are few reports about laparoscopic approach after liver transplantation (LT). The aim of this paper is to analyze in terms of feasibility and therapeutic effectiveness an initial experience with laparoscopy in patients who have had a liver transplantation.MethodsLaparoscopic procedures were divided into “early” and “late” laparoscopy.ResultsA total of 10 laparoscopic procedures after LT were performed in 9 patients: 3 early and 7 late. The early laparoscopic procedures were performed in 3 patients who had a torpid evolution in their liver transplant: 2 were diagnostic only and 1 was also therapeutic. There were no intraoperative events or conversions. We recorded 2 complications. In 7 patients a late laparoscopy was performed: 4 in the upper abdomen and 3 in the lower abdomen. Of the 4 in the upper abdomen, 3 were liver procedures and 1 was in the transverse colon, on the other side; in addition, 2 laparoscopic inguinal hernia repairs and 1 laparoscopic appendectomy also were performed. None of these 7 cases was converted, and there were no intraoperative events.ConclusionsThe early postoperative period, in critically ill patients diagnostic and eventually therapeutic laparoscopy was feasible and effective in our cases. Late laparoscopy in the upper abdomen is difficult due to adhesions and adds to the risk of poor graft function, but was feasible for both diagnostic and therapeutic purposes. Late laparoscopy in the lower abdomen with good graft function has the same safety and efficacy as those performed on nontransplanted patients.