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Subtotal cholecystectomy.

D J Cottier1, C McKay, J R Anderson

  • 1University Department of Surgery, Royal Infirmary, Glasgow, UK.

The British Journal of Surgery
|November 1, 1991
PubMed
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Subtotal cholecystectomy is a safe procedure for complex gallbladder cases. This gallbladder surgery offers a definitive solution when standard cholecystectomy poses risks, with minimal complications observed.

Area of Science:

  • Gastroenterology and Hepatobiliary Surgery
  • Surgical Techniques
  • Patient Outcomes

Background:

  • Standard cholecystectomy may be contraindicated in cases of severe inflammation, fibrosis, or portal hypertension.
  • Alternative procedures like cholecystostomy may have limitations.
  • Subtotal cholecystectomy presents a viable option for complex gallbladder disease.

Purpose of the Study:

  • To evaluate the safety and efficacy of subtotal cholecystectomy.
  • To assess outcomes in patients with specific indications for this procedure.
  • To compare subtotal cholecystectomy with other surgical options.

Main Methods:

  • A retrospective review of 11 patients undergoing subtotal cholecystectomy over a 5-year period.
  • Analysis of indications including severe inflammation/fibrosis, portal hypertension, and Mirizzi syndrome.

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  • Assessment of in-hospital morbidity, mortality, and long-term post-operative sequelae.

    • Main Results:

    • Subtotal cholecystectomy was performed in 3.8% of all cholecystectomies.
    • Indications included severe inflammation/fibrosis (6), portal hypertension (3), and Mirizzi syndrome (2).
    • No deaths occurred; minor morbidity was observed. One patient developed a bile duct stone 21 months post-operatively. Mean follow-up was 29 months with no other sequelae.

    Conclusions:

    • Subtotal cholecystectomy is a safe and effective procedure for patients with challenging gallbladder conditions.
    • It serves as a definitive alternative to standard cholecystectomy when risks are elevated.
    • This approach is preferable to cholecystostomy in select patient populations.