The use of laparoscopic subtotal cholecystectomy for complicated cholelithiasis

Abstract

Laparoscopic subtotal cholecystectomy is a viable procedure during cholecystectomy in which Calot's triangle cannot be dissected. It averts the need for a laparotomy.

Residual gallstone disease — Laparoscopic management

“…Subtotal cholecystectomy has been recommended as a safe and viable option in patients where anatomical distortion at Calot's triangle precludes a safe dissection [7,8,[13][14][15]. Conversion rate to open surgery is higher for patients with acute cholecystitis than in those without acute cholecystitis.…”

“…The condition may arise as a result of inadequate dissection of cystic duct or a partial or ORIGINAL ARTICLE subtotal cholecystectomy. Patients with severe anatomical distortion, tissue friability or poor general condition are often managed by performing a salvage partial cholecystectomy or a cholecystostomy [6][7][8][9][10].…”

Technical solutions for difficult laparoscopic cholecystectomies: Fundus-first technique and partial cholecystectomy

“…It is well-known that the rate of wound infection, bile leaks, CBD injury, and cardiopulmonary complications is lower in LPC than in open surgery. [22] Also, the median duration of hospitalization in open surgery is 3-10 days; [23][24][25][26] our median duration of hospitalization was 3.25 days (2-11 days).…”

“…[6,21] Palliative or minimally invasive techniques such as percutaneous drainage and ERCP are the most efficient treatments for such complications following LPC. [22] The incidence of postoperative ERCP after LPC was reported as 4.1%, and the most common indications for ERCP after LPC were retained stones (59%) and bile leakage (31.5%). [6] In our study, postoperative ERCP was performed in two of the six patients who underwent LPC.…”

The use of laparoscopic subtotal cholecystectomy for complicated cholelithiasis

“…We read with interest the article entitled The Use of Laparoscopic Subtotal Cholecystectomy for Complicated Cholelithiasis published in Surgical Endoscopy [1]. We congratulate the authors for their results, and we agree with their conclusion that laparoscopic subtotal cholecystectomy (LSC) is a valuable procedure during laparoscopic cholecystectomy (LC) when Calot's triangle cannot be dissected and that it will prevent unnecessary laparotomy.…”