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Open cholecystectomy in the laparoscopic era.
P J Jenkins1, H M Paterson, R W Parks
1Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK.
The British Journal of Surgery
|July 27, 2007
Summary
Primary open cholecystectomy is still common for gallbladder disease, especially after prior abdominal surgery or for emergencies. Specific techniques are crucial for success, but training may be limited.
Area of Science:
- Surgical Techniques
- Gastrointestinal Surgery
- Abdominal Surgery
Background:
- Laparoscopic cholecystectomy advancements may reduce open cholecystectomy experience.
- Investigating current practices for primary open cholecystectomy is essential.
Purpose of the Study:
- To examine the indications for primary open cholecystectomy.
- To analyze the techniques employed in primary open cholecystectomy.
Main Methods:
- Analysis of a prospective surgical audit database.
- Review of demographic, diagnostic, and procedural data for 3100 patients over 5 years.
Main Results:
- 123 (4.0%) primary and 219 (7.4%) converted open cholecystectomies were performed.
- Indications included prior open surgery (22.7%) and emergency peritonitis (19.5%).
- Fundus-first approach used in 53.7% of primary open procedures.
Conclusions:
- Primary open cholecystectomy remains a significant procedure for gallbladder disease.
- Expertise in specific techniques is vital for managing complex cases.
- Current surgical training may limit exposure to these essential techniques.