Short and long term outcomes of laparoscopic fenestrating or reconstituting subtotal cholecystectomy versus laparoscopic total cholecystectomy in the management of acute cholecystitis

Loh, Alex; Chean, Chung Shen; Durkin, Damien; Bhatt, Anand; Athwal, Tejinderjit

doi:10.1016/j.hpb.2021.09.018

Cited by 17 publications

(9 citation statements)

References 17 publications

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“…[ 25 ] In addition, reconstituting the SC was found to have more long-term morbidity. [ 26 ] In cases of easy access to ERCP and interventional procedures, fenestrating the SC should be preferred to avoid serious biliary or vascular injuries during emergency operations.…”

Section: Discussionmentioning

confidence: 99%

Does the subtotal cholecystectomy rate for acute cholecystitis change with previous endoscopic retrograde cholangiopancreatography?

Kesgin

2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:Acute cholecystitis is one of the most common emergent surgeries. As a safe alternative in challenging operations, laparoscopic subtotal cholecystectomy (LSC) is widely used. We questioned whether the results in acute cholecystitis cases changed with a history of endoscopic retrograde cholangiopancreatography (ERCP). When we searched the literature, we could not find a study focusing on the subtotal cholestectomy results in acute cholecystitis. In our study, we aimed to investigate whether the history of ERCP affects the rates of subtotal cholecystectomy (SC) in acute cholecystitis. METHODS:The results of patients (n=470) who underwent surgery for acute cholecystitis at our clinic between 2016 and 2019 were retrospectively evaluated. The patients were divided into two groups according to their history of ERCP. The primary outcome was the SC rate. The secondary outcomes were conversion to open, postoperative complications, serious complications, operative duration, and length of hospital stay. RESULTS:The standard group included 437 patients, whereas the ERCP group included 33 patients. A total of 16 patients underwent SC, with 15 in the standard group and 1 in the ERCP group. There was no significant difference in terms of SC rates between groups (P=0.902). While four cases of operation were completed with conversion to open in the non-ERCP group, no conversion was seen in the ERCP group (P=0.581). No significant differences were detected between the groups in terms of complications, serious complications, operation duration, length of hospital stay, and mortality. CONCLUSION:The results of this study showed that ERCP is not related to an increased rate of SC and conversion in patients with acute cholecystitis. Laparoscopic cholecystectomy for acute cholecystitis can be safely performed in patients with a history of ERCP. LSC is a safe procedure in challenging patients, and fenestrating SC can be preferred to avoid hazardous consequences in such cases.

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Section: Discussionmentioning

confidence: 99%

Does the subtotal cholecystectomy rate for acute cholecystitis change with previous endoscopic retrograde cholangiopancreatography?

Kesgin

2023

Ulus Travma Acil Cerrahi Derg

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“…58 Our study may have overestimated the overall rate of wound infection because it included individuals with acute cholecystitis. It is more common for people with acute cholecystitis to develop wound infections than those with simple cholelithiasis [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Outcome of laparoscopic cholecystectomy with and without drains at Ayub Teaching Hospital

Akbar

Hussain

Hafeez

et al. 2022

ijhs

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Introduction: In terms of surgery, cholecystectomy performed using laparoscopy is the current standard of care for Cholelithiasis. This operation is by far the most common type of surgery done today. However, the literature is still divided on whether or not drainage should be performed following an elective laparoscopic cholecystectomy. Objectives: The aim of this study was to examine whether or not patients undergoing laparoscopic cholecystectomy at Ayub Teaching Hospital, Abbottabad were more likely to develop an infection in the wound if a drain was used. Results evaluation: Checks for wound infections were performed for up to a month after surgery to determine the outcome. Study Design: The study used a randomized controlled trial design. Settings: The study lasted for six months, from January 01, 2022, to June 30, 2022, and took place in the Department of General Surgery, Ayub Teaching Hospital, Abbottabad. Subjects: Patients having laparoscopic cholecystectomy for gall bladder disease were used as subjects.

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“…The question regarding the probability of symptomatic gallbladder remnant events in the future and the necessity of elective completion cholecystectomy remains open, as this depends on the number of specific factors associated with subtotal cholecystectomy. Examples of these factors include the type of completion of subtotal cholecystectomy (controversial conclusions) [7,[35][36][37][38], the presence or absence of bile leak after subtotal cholecystectomy [39], and retained gallstones within the gallbladder remnant [40]. According to a systematic review, the overall incidence of retained gallstones, recurrent biliary events, and completion cholecystectomy ranges between 0.8% and 3% [8].…”

Section: Specific Target When Planning Elective Liver Resection and T...mentioning

confidence: 99%

Subtotal cholecystectomy as an approach to preventing injury in the left-sided gallbladder in the emergency surgery setting: A case study

Lunevicius,

Chawdhery,

Jones

2024

JCTR

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A left-sided gallbladder is an unusual anatomic variation that makes gallbladder surgery challenging. Two systematic reviews on surgery for left-sided gallbladder highlighted high iatrogenic bile duct injury rates of 4.4% and 7.3%. This paper reports a female in her 40s with symptoms of acute calculous cholecystitis admitted to a secondary health-care center. After inserting four ports through standard sites for conventional gallbladder surgery, laparoscopic inspection revealed a phlegmonous left-sided gallbladder. No discordant situs of abdominal viscera was noted. Laparoscopic surgery was converted to open subtotal closed-tract cholecystectomy. No post-operative complications related to the surgical site were observed. A left-sided gallbladder affected by severe inflammation and infection is an extraordinary condition that should be considered as a risk factor. If an inflamed left-sided gallbladder is encountered, emergency subtotal cholecystectomy is an alternative to total cholecystectomy when the circumstances to adopt the strategies of a culture of safety in cholecystectomy for complete removal of the gallbladder are unfavorable. Relevance for Patients: Subtotal cholecystectomy in patients with left-sided gallbladder reduces the risk for bile duct injuries, outweighing the potential side effects stemming from this surgical approach.

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Short and long term outcomes of laparoscopic fenestrating or reconstituting subtotal cholecystectomy versus laparoscopic total cholecystectomy in the management of acute cholecystitis

Cited by 17 publications

References 17 publications

Does the subtotal cholecystectomy rate for acute cholecystitis change with previous endoscopic retrograde cholangiopancreatography?

Does the subtotal cholecystectomy rate for acute cholecystitis change with previous endoscopic retrograde cholangiopancreatography?

Outcome of laparoscopic cholecystectomy with and without drains at Ayub Teaching Hospital

Subtotal cholecystectomy as an approach to preventing injury in the left-sided gallbladder in the emergency surgery setting: A case study

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