Abandoned Cholecystectomy: A Single-Center Retrospective Cross-Sectional Cohort Study, 2013-2024

Introduction: Abandoned cholecystectomy (AbC) is a rarely studied bailout procedure in gallbladder surgery. This study aimed to estimate the annual utilization rates of AbC, provide AbC-specific clinical outcome data, and discuss AbC-related themes in a broader context. Materials and Methods: This retrospective cross-sectional study was conducted at a university hospital and comprised patients who underwent AbC between 2013 and 2023. The final follow-up was conducted on January 31, 2024. The dataset was investigated using exploratory data analysis. Results: In total, 20 female and 17 male patients (mean age, 62.5 years) underwent AbC. The mean AbC rate in the elective surgery setting was 1%. A chronic pericholecystic inflammatory mass was the most common cause of AbC (n = 22; 59.5%). The 30-day postoperative outcomes included a prolonged length of hospital stay (median, 2), readmission rate of 18.9% (four emergencies; three planned), second surgical procedure rate of 13.5% (two emergencies; three planned), and iatrogenic injury rate of 5.4% (2 patients). Long-term outcomes included six emergency admissions with acute biliopancreatic events (16.7%). Fifteen patients underwent elective secondary gallbladder surgeries, including 11 total cholecystectomies, three subtotal cholecystectomies (20%), and one cholecystolithotomy with tube cholecystostomy. Conclusions: AbC is preventable in most cases. Adherence to guidelines for managing acute calculous cholecystitis is the key. The decision to convert laparoscopic surgery to open or bail out by abandoning cholecystectomy when other options for damage control and limitation surgery are infeasible should be made early to avoid the burden associated with laparoscopic surgery to expose the gallbladder.