Related Experiment Video
Updated: Apr 9, 2026
Application of Laparoscopic Ultrasonography in Primary Choledochal Suture during Combined Two-lens Surgery
Published on: March 28, 2025
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.
Background:
The concept of laparoscopic subtotal cholecystectomy (LSC), without approaching Calot's triangle to avoid both laparotomy and serious complications, is not widely accepted. In this study, we evaluated the outcomes of LSC for severe cholecystitis when dissection of the cystic duct and cystic artery is hazardous.
Methods:
From January 2004 to December 2013, 110 consecutive patients who underwent LSC without ligation of the cystic duct and vessels were enrolled in this retrospective study. Their clinical records, including operative records and outcomes, had been entered into a prospectively maintained database and were analyzed.
Results:
The mean operating time and blood loss were 121 min and 33.8 ml, respectively. All LSCs were completed without conversion to an open procedure. No injuries to the bile duct or vessels were experienced. Postoperative complications occurred in ten (9.1%) patients, including subhepatic hematoma in 3, bile leakage in 3, and subhepatic abscess in 1. Patients recovered from complications without requiring re-operation. During follow-up periods (mean 30.7 months), symptomatic biliary stone diseases relapsed in three patients (2.7%) and were successfully treated by endoscopic management.
Conclusions:
LSC without an attempt to dissect Calot's triangle is a safe and feasible procedure that can avoid conversion to laparotomy.
