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Laparoscopic modified subtotal cholecystectomy for difficult gall bladders: A single-centre experience.
Mohan Raj Harilingam1, Ashish Kiran Shrestha2, Sanjoy Basu2
1Department of Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, UK.
Journal of Minimal Access Surgery
|June 3, 2016
Summary
Laparoscopic modified subtotal cholecystectomy (LMSC) is a safe and effective technique for difficult gall bladder diseases, avoiding conversion to open surgery in 6.5% of cases. This method offers a positive outcome for patients with complex gall bladder conditions.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Abdominal Surgery
Background:
- Laparoscopic cholecystectomy (LC) is the standard treatment for gall bladder diseases.
- Conversion to open surgery is often necessary for cases with distorted anatomy at Calot's triangle to prevent biliovascular injury.
Purpose of the Study:
- To evaluate the suitability, safety, and outcomes of a laparoscopic modified subtotal cholecystectomy (LMSC) technique.
- To determine if LMSC can reduce the rate of conversion to open surgery in complex gall bladder cases.
Main Methods:
- A retrospective analysis of prospectively collected data from 993 patients undergoing cholecystectomy between August 2007 and January 2015.
- Detailed recording and analysis of patient demographics, operative details, intra- and postoperative complications, and hospital stay.
Main Results:
- Out of 979 laparoscopic procedures, 64 patients (6.5%) underwent LMSC, often due to dense adhesions, acute inflammation, or severe contraction.
- LMSC was associated with a median hospital stay of 1 day.
- The overall conversion rate to open surgery was 1.3%.
Conclusions:
- Laparoscopic modified subtotal cholecystectomy (LMSC) is a feasible and safe technique for managing difficult gall bladder cases.
- LMSC successfully avoided conversion to open surgery in 6.5% of patients, demonstrating a positive outcome.
