Clinical outcomes of subtotal cholecystectomy performed for difficult cholecystectomy

Shin, Min‐Ho; Choi, Nam Kyu; Yoo, Youngsun; Kim, Yooseok; Kim, Sung Soo; Mun, Seong-Pyo

doi:10.4174/astr.2016.91.5.226

Cited by 35 publications

(34 citation statements)

References 18 publications

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“…Our study observed gallbladder wall thickness and presence of multiple calculi as risk factor for a laparoscopic subtotal cholecystectomy as seen in the study done by Shin et al [18] This was also in concordance with the study conducted by Randhawa and Pujahari [19] and Lipman et al, [20] predicting the difficulty of laparoscopic cholecystectomy and conversion.…”

Section: Discussionsupporting

confidence: 92%

Clinical Outcome of Laparoscopic Subtotal Cholecystectomy in the Treatment of Complicated Cholecystitis

Gupta¹,

Karwal²,

Singla³

et al. 2018

jemds

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BACKGROUND Laparoscopic cholecystectomy has replaced open cholecystectomy as the surgical procedure of choice for symptomatic gallstones. The presence of risk factors such as difficult Calot's triangle, various liver pathologies like hard fibrotic liver tissue as seen in chronic cholecystitis, severe adhesions between the liver and gallbladder wall, oedematous tissue in severe acute cholecystitis and neovascularity as in cirrhotic liver make the dissection very difficult and dangerous. The present study was conducted to evaluate the role and outcome of laparoscopic subtotal cholecystectomy in the treatment of complicated cholecystitis. MATERIALS AND METHODS This was a descriptive study conducted on all patients who underwent laparoscopic subtotal cholecystectomy at Dayanand Medical College, Ludhiana from 1st January 2014 to 30th June 2017. Details of the patients were retrieved and analysed for demographic data, history and clinical findings, investigations, operative findings, length of hospital stay, complications and outcome. RESULTS The total number of laparoscopic cholecytectomies done during the total duration of the study was 1,926. The overall incidence of laparoscopic subtotal cholecystectomy in our study was 1.1%. CONCLUSION Laparoscopic subtotal cholecystectomy may be a safe alternative to open subtotal cholecystectomy in patients with various forms of complicated cholecystitis. If difficulty is encountered when dissecting the neck and Calot's triangle, isolating the cystic duct is unnecessary and the conversion rate decreases by devising alternate methods for handling hostile Calot's triangle as described in this study. This study demonstrates that laparoscopic subtotal cholecystectomy is associated with a reduced risk of severe complications in the patients with complicated cholecystitis.

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Section: Discussionsupporting

confidence: 92%

Clinical Outcome of Laparoscopic Subtotal Cholecystectomy in the Treatment of Complicated Cholecystitis

Gupta¹,

Karwal²,

Singla³

et al. 2018

jemds

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“…found lower rates of infectious complication when the posterior wall of the GB was left behind. [ 8 ] Subgroup analysis showed that laparoscopic approach had a lower rate of wound infection. Similar findings were confirmed by Elshaer et al .…”

Section: Discussionmentioning

confidence: 99%

“…[ 7 ] and Shin et al . [ 8 ] Recently, Strasberg et al . divided it into 'fenestrating' and 'reconstituting' types.…”

Section: Introductionmentioning

confidence: 99%

Is a difficult gallbladder worth removing in its entirety? – Outcomes of subtotal cholecystectomy

et al. 2020

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Background: Laparoscopic Cholecystectomy one of the commonest procedures performed worldwide isn't spared from the risks of disastrous iatrogenic complications. In patients with obscured anatomy, the idea of performing a safe total cholecystectomy can be hindered with a high risk of biliovascular injuries. In such a situation STC (subtotal cholecystectomy) comes to the rescue, where the diseased organ can be tackled fairly, without any further damage. Aims and Objectives: The primary aim was to look at the immediate and long-term outcomes of subtotal cholecystectomy. Subgroup analysis was done based on demographics, indications and surgical approach. Materials and Methods: We reviewed our prospectively maintained computerized operation database over nine years. STC was defined as leaving behind any portion of gallbladder other than the cystic duct. They were subclassified as per the description given by Palanivelu. Patients were evaluated with laboratory and radiological assessment. Results: A total of 70 out of 602 patients (11.6%) underwent STC. Dense adhesion at the calot's was the most important reason for STC. Subtype B was the most common. Nine patients (12.85%) had a bile leak in the postoperative period. There were no biliary/vascular injuries and 30-day mortality was zero. 22.8% developed SSI (surgical site infection). Over a median follow up of 38 months (range 5-98), clinical examination, LFT and USG revealed no abnormality in any of the patients. Conclusion: Subtotal cholecystectomy is a useful alternative during difficult gallbladder surgery. It should be considered early into the procedure preferably prior to conversion to an open procedure. Biliovascular injuries can be avoided and the Immediate and long-term outcomes are acceptable.

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“…Many studies have evaluated the feasibility of LSC in cases of difficult gallbladder . The technique now appears to be well established.…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic subtotal cholecystectomy (LSC), which avoids hazardous dissection at Calot's triangle, has been recognized as a safe and feasible alternative to conversion to laparotomy in cases of severe cholecystitis or liver cirrhosis . However, the procedure may be associated with an increased risk of residual or recurrent stones in the gallbladder remnant .…”

Section: Introductionmentioning

confidence: 99%

Closure of the cystic duct orifice in laparoscopic subtotal cholecystectomy for severe cholecystitis

Matsumura

Komatsu

Komaya

et al. 2017

Asian J Endoscop Surgery

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Clinical outcomes of subtotal cholecystectomy performed for difficult cholecystectomy

Cited by 35 publications

References 18 publications

Clinical Outcome of Laparoscopic Subtotal Cholecystectomy in the Treatment of Complicated Cholecystitis

Clinical Outcome of Laparoscopic Subtotal Cholecystectomy in the Treatment of Complicated Cholecystitis

Is a difficult gallbladder worth removing in its entirety? – Outcomes of subtotal cholecystectomy

Closure of the cystic duct orifice in laparoscopic subtotal cholecystectomy for severe cholecystitis

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