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Updated: Nov 28, 2025

Application of Laparoscopic Ultrasonography in Primary Choledochal Suture during Combined Two-lens Surgery

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Laparoscopic Subtotal Cholecystectomy for the Difficult Gallbladder: A Safe Alternative.

Chaya Shwaartz^1,2, Ron Pery^1,2, Mordechay Cordoba^1,2

¹Department of Surgery and Transplantation B, Sheba Medical Center, Tel Hashomer, Israel.

The Israel Medical Association Journal : IMAJ

|November 25, 2020

Summary

Laparoscopic subtotal cholecystectomy effectively avoids bile duct injury in difficult gallbladder removal cases. This technique offers acceptable morbidity and reduces the need for conversion to open surgery.

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Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery

Published on: February 10, 2023

Area of Science:

Surgical techniques
Gastrointestinal surgery
Minimally invasive procedures

Background:

Cholecystectomy requires precise cystic duct identification and closure.
Inflammatory changes can obscure anatomy, complicating dissection.
Subtotal cholecystectomy facilitates gallbladder removal while minimizing risk in difficult anatomy.

Purpose of the Study:

To report on the clinical experience with laparoscopic subtotal cholecystectomy.
To evaluate its safety and efficacy in challenging cases.

Main Methods:

Laparoscopic subtotal cholecystectomy performed when critical view of safety was not achievable.
Technique involved opening Hartmann's pouch, stone removal, stump closure, and fundus excision.
Data collected on patient demographics, operative, and postoperative courses.

Main Results:

53 patients underwent the procedure between 2010-2018.
Acute cholecystitis was the primary indication.
42 out of 53 patients experienced an uneventful postoperative course; no bile duct injuries occurred.

Conclusions:

Laparoscopic subtotal cholecystectomy is effective for preventing bile duct injury when cystic duct identification is challenging.
The procedure demonstrates acceptable morbidity and avoids conversion to open surgery in complex scenarios.