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Damage-control laparoscopic partial cholecystectomy with an endoscopic linear stapler.

Beyza Özçınar1, Ecem Memişoğlu1, Ali Fuat Kaan Gök1

  • 1Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey.

Turkish Journal of Surgery
|June 8, 2017
PubMed
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Laparoscopic partial cholecystectomy using an endoscopic linear stapler is a safe alternative for severe Calot

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Minimally Invasive Surgery

Background:

  • Severe inflammation and fibrosis of Calot's triangle pose challenges for standard cholecystectomy.
  • Damage-control procedures are described, but novel techniques are explored.

Purpose of the Study:

  • To describe the technique and outcomes of laparoscopic partial cholecystectomy using an endoscopic linear stapler.
  • To evaluate the safety and feasibility of this approach in challenging cases.

Main Methods:

  • Five patients with acute cholecystitis and severe Calot's triangle inflammation/fibrosis underwent laparoscopic partial cholecystectomy.
  • The procedure involved gallbladder resection, leaving a remnant pouch, and transection at the neck or Hartmann's pouch.
  • An endoscopic linear stapler was utilized for gallbladder closure.
Keywords:
Acute cholecystitisdamage control surgeryendoscopic linear staplerlaparoscopypartial cholecystectomy

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Main Results:

  • All five patients tolerated the procedure, with a mean operative time of 140 minutes.
  • No biliary leakage was observed; surgical drains were used in all cases.
  • One patient required subsequent endoscopic retrograde cholangiopancreatography for remnant common bile duct calculi.

Conclusions:

  • Laparoscopic partial cholecystectomy is a safe and feasible alternative when visualization of Calot's triangle is compromised.
  • This technique offers an acceptable morbidity rate compared to open surgery in complex cases.