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Laparoscopic subtotal cholecystectomy for severe cholecystitis
Yuji Shingu1, Shunichiro Komatsu2, Shinji Norimizu3
1Department of Digestive Surgery, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya, 466-8650, Japan. shingu@nagoya2.jrc.or.jp.
Surgical Endoscopy
|June 21, 2015
Summary
Laparoscopic subtotal cholecystectomy (LSC) without dissecting Calot's triangle is a safe option for severe cholecystitis, avoiding open surgery and complications. This technique offers a feasible alternative when dissection is hazardous.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Laparoscopic subtotal cholecystectomy (LSC) without approaching Calot's triangle is not widely accepted.
- This approach aims to avoid laparotomy and serious complications.
- Evaluation of LSC in severe cholecystitis with hazardous dissection is crucial.
Purpose of the Study:
- To evaluate the outcomes of LSC in patients with severe cholecystitis.
- To assess the safety and feasibility of LSC when dissection of the cystic duct and artery is hazardous.
- To determine if LSC can avoid conversion to open surgery.
Main Methods:
- Retrospective analysis of 110 consecutive patients undergoing LSC from January 2004 to December 2013.
- Patients underwent LSC without ligation of the cystic duct and vessels.
- Clinical records and outcomes were analyzed from a prospectively maintained database.
Main Results:
- Mean operating time was 121 minutes with 33.8 ml blood loss.
- All procedures were completed laparoscopically without conversion.
- Postoperative complications (9.1%) included hematoma, bile leakage, and abscess, managed conservatively.
Conclusions:
- Laparoscopic subtotal cholecystectomy without dissecting Calot's triangle is safe and feasible.
- This technique can effectively avoid conversion to laparotomy.
- It presents a viable option in cases of severe cholecystitis with difficult anatomy.
