Laparoscopic Subtotal Cholecystectomy: A Review of 56 Procedures

Abstract

Laparoscopic subtotal cholecystectomy is safe, feasible, and effective and may help prevent conversion to open surgery in carefully selected patients with difficult cholecystectomies.

Residual gallstone disease — Laparoscopic management

“…We have also reported a similar experience, especially in patients with portal hypertension, Mirizzi Syndrome, and inflammation at Calot's triangle with severe anatomical distortion wherein a laparoscopic subtotal cholecystectomy was the only viable surgical option [16]. Seven patients from our series were conversions from an attempted LC.…”

Presentation and management of gallbladder remnant after partial cholecystectomy

“…The presentation of a gallbladder remnant can be variable not only in terms of clinical features, but also in relation to the time interval after cholecystectomy. 1,[10][11][12][13][14] These patients can remain asymptomatic, 1,13,14 or they can present with acute symptoms (biliary colic, acute cholecystitis or acute pancreatitis)…”

“…1,[8][9][10][11][12][13][14] Although there are no pathognomic symptoms, the persistence of symptoms after cholecystectomy should alert the clinician to the possibility of a gallbladder remnant, especially when coupled with radiation of pain to the shoulder, food intolerance, nausea or jaundice. 1,15 Similarly, the timing of presentation is also very variable, with patients presenting at any time between less than 1 year and upto 25 years after cholecystectomy.…”

Damage-control laparoscopic partial cholecystectomy with an endoscopic linear stapler

“…In case of severe Calot's triangle inflammation and fibrosis, the rate of injury to the biliary tract and portal structures increase. Several damage-control procedures have been described in the literature for such circumstances (1)(2)(3)(4)(5).…”