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Calculus left in remnant gallbladder cause long-term complications in patients undergoing subtotal cholecystectomy

Atsushi Kohga1, Kenji Suzuki1, Takuya Okumura1

  • 1Division of Surgery, Fujinomiya City General Hospital, Shizuoka, Japan.

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
|October 25, 2018
PubMed

Insights

Subtotal cholecystectomy (SC) can lead to significant long-term complications, particularly residual calculus in the common bile duct. Gallbladder remnant size is a key risk factor for these adverse outcomes after SC.

Area of Science:

  • Gastroenterology
  • Surgical Outcomes
  • Biliary Tract Surgery

Background:

  • Long-term outcomes following Subtotal Cholecystectomy (SC) are infrequently reported.
  • Understanding these outcomes is crucial for patient management and surgical decision-making.

Purpose of the Study:

  • To analyze the risk factors for long-term complications after Subtotal Cholecystectomy (SC).
  • To compare perioperative and long-term clinical factors between SC and total cholecystectomy in patients with acute cholecystitis (AC).

Main Methods:

  • Retrospective analysis of 59 patients who underwent "reconstituting" SC between January 2005 and July 2017.
  • Comparison of SC (n=48) versus total cholecystectomy (n=378) in AC patients regarding clinical factors.
  • Magnetic resonance imaging (MRI) used to assess remnant gallbladder size in 35 SC patients.

Main Results:

  • 14.3% of SC patients experienced long-term complications, including residual common bile duct calculus (12/59).
  • Remnant gallbladder size on postoperative MRI was significantly associated with long-term complications (p=0.009).
  • SC patients with AC had a significantly higher incidence of residual common bile duct calculus (16.6% vs 0.7%) compared to total cholecystectomy.

Conclusions:

  • Subtotal cholecystectomy is associated with a notable rate of long-term complications, primarily related to remnant calculus.
  • Gallbladder remnant size is a critical predictor of postoperative complications after SC.
Abstract

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