Introduction:Peritoneal dialysis is a well-accepted replacement therapy in patients with
end-stage renal disease. There are many different options adopted on how to
insert a peritoneal dialysis catheter. In our institution, a laparoscopic
insertion has become the method of choice for providing peritoneal dialysis
access in adult patients. The aim of this study was to analyze surgical
outcomes of patients after laparoscopically assisted placement of a PD
catheter some of them after concomitant cholecystectomy or hernioplasty.Methods:We have evaluated 70 consecutive patients from 1st of October 2015 to 30th of
April 2020 who underwent laparoscopic insertion of a peritoneal dialysis
catheter. Demographic data, details about surgery and about peri- and
postoperative complications were gathered.Results:Out of 70 enrolled patients, 15 had gallstones (21%) and underwent
concomitant laparoscopic cholecystectomy. Three patients (4%) had abdominal
wall hernia and underwent concomitant hernioplasty. We observed no
perioperative complications connected with any of the performed procedures.
There was one early postoperative complication: an early leak of dialysate
fluid. Late complications were observed in nine patients (13%): mechanical
catheter problems (two patients), peritonitis (three patients), skin
exit-site infections (two patients), peri-catheter leak (one patient), and
port-site hernia (one patient).Conclusions:For all patients with concomitant gallbladder disease or abdominal wall
hernias we suggest to perform synchronous surgeries, due to finding no more
complications after concomitant procedures in comparison to patients in whom
only a PD catheter was inserted. Concomitant procedures are done to spare
patients two separate procedures and to avoid possible complications. We
also suggest using the cholecystectomy first, PD catheter insertion second
approach for having excellent peri- and postoperative results.