Posterior Calot’s triangle approach would be a better choice for chronic atrophic cholecystitis: a retrospective controlled study

Abstract

Objective Compare the clinical efficacy of anterior and posterior Calot’s triangle approach in laparoscopic cholecystectomy (LC) for chronic atrophic cholecystitis, to find out which approach is much safer and more reliable.Methods From June 2020 to June 2022, 102 patients with chronic atrophic cholecystitis underwent LC in our hospital. They were divided into anterior Calot’s triangle approach group and posterior Calot’s triangle approach group. And their clinical data, intraoperative conditions, surgical results, and postoperative recovery were analyzed.Results LC was performed in 41 females and 28 males by the anterior Calot’s triangle approach, and in 20 females and 13 males by the posterior Calot’s triangle approach. There were no differences in age, gender, and BMI between the two groups (p > 0.05). The probability of rupture of cystic artery between both groups was not significantly different (p = 0.549), and the intraoperative blood loss was more in the anterior group (p = 0.014). The operative time of the posterior approach appeared to be shorter (p = 0.013). Bile duct injury and conversion to open cholecystectomy revealed no significant difference (p > 0.05). The recovery time of gastrointestinal function, wound infection, white blood cell count, liver function and postoperative hospital stay were found to be not significantly different (p > 0.05).Conclusion By the posterior Calot’s triangle approach, LC is a convenient and feasible surgical procedure for chronic atrophic cholecystitis with less blood loss and can become easier to perform without increasing the risk of surgery.