Usefulness of Laparoscopic Subtotal Cholecystectomy with Operative Cholangiography for Severe Cholecystitis

Overview

Journal Surg Today

Specialty General Surgery

Date 2013 Jun 6

PMID 23736889

Citations 11

Authors

Jun Kuwabara

Yuji Watanabe

Kazuhiro Kameoka

Atsushi Horiuchi

Kouichi Sato

Shungo Yukumi

Motohira Yoshida

Yuji Yamamoto

Hiroki Sugishita

Affiliations

Soon will be listed here.

Abstract

Purpose: Cholecystectomy can become hazardous when inflammation develops, leading to anatomical changes in Calot's triangle. We attempted to study the safety and efficacy of laparoscopic subtotal cholecystectomy (LSC) to decrease the incidence of complications and the rate of conversion to open surgery.

Methods: Patients who underwent LSC between January 2005 and December 2008 were evaluated retrospectively. The operations were performed laparoscopically irrespective of the grade of inflammation estimated preoperatively. However, patients with severe inflammation of the gallbladder underwent LSC involving resection of the anterior wall of the gallbladder, removal of all stones and placement of an infrahepatic drainage tube. To prevent intraoperative complications, including bile duct injury, intraoperative cholangiography was performed.

Results: LSC was performed in 26 elective procedures among 26 patients (eight females, 18 males). The median patient age was 69 years (range 43-82 years). The median operative time was 125 min (range 60-215 min) and the median postoperative inpatient stay was 6 days (range 3-21 days). Cholangiography was performed during surgery in 24 patients. One patient underwent postoperative endoscopic sphincterotomy for a retained common bile duct stone that was found on cholangiography during surgery. Neither complications nor conversion to open surgery were encountered in this study.

Conclusions: LSC with the aid of intraoperative cholangiography is a safe and effective treatment for severe cholecystitis.

Citing Articles

Intraoperative imaging and management of common duct stones during subtotal cholecystectomy.

Johnston T, Cotter R, Soybel D, Santos B Surg Endosc. 2024; 38(10):6083-6089.

PMID: 39187731 DOI: 10.1007/s00464-024-11143-9.

Navigation by modified and dynamic intraoperative cholangiography during laparoscopic subtotal cholecystectomy for difficult gallbladder.

Chikamori F, Yamada R, Ueta K, Onishi K, Yoshida M, Tanida N Radiol Case Rep. 2023; 18(4):1585-1591.

PMID: 36845284 PMC: 9947179. DOI: 10.1016/j.radcr.2023.01.026.

Review of the Literature on Partial Resections of the Gallbladder, 1898-2022: The Outline of the Conception of Subtotal Cholecystectomy and a Suggestion to Use the Terms 'Subtotal Open-Tract Cholecystectomy' and 'Subtotal Closed-Tract....

Lunevicius R J Clin Med. 2023; 12(3).

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Subtotal cholecystectomy: is it a safe option for difficult gall bladders?.

Ibrahim R, Abdalkoddus M, Mahendran B, Mownah O, Nawara H, Aroori S Ann R Coll Surg Engl. 2021; 105(5):455-460.

PMID: 34821508 PMC: 10149244. DOI: 10.1308/rcsann.2021.0291.

Subtotal cholecystectomy for difficult acute cholecystitis: how to finalize safely by laparoscopy-a systematic review.

Toro A, Teodoro M, Khan M, Schembari E, Di Saverio S, Catena F World J Emerg Surg. 2021; 16(1):45.

PMID: 34496916 PMC: 8424983. DOI: 10.1186/s13017-021-00392-x.

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