Clinical Outcomes and Complications Following Subtotal Cholecystectomy: A Single-Centre Cohort Analysis

Area of Science:

• Gastroenterology
• Surgical Innovation
• Biliary Surgery

Background:

• Subtotal cholecystectomy (STC) is gaining traction for managing challenging gallbladders, aiming to minimize common bile duct (CBD) injury.
• Current STC techniques and outcomes show institutional variability, with limited standardized reporting.

Purpose of the Study:

• To assess peri-operative and post-operative outcomes of STC at a tertiary center.
• To identify pre-operative factors predicting the need for STC, including prior gallstone admissions and specific imaging markers.

Main Methods:

• Retrospective cohort study of 39 patients undergoing STC (Jan 2021-Jan 2024).
• Data collected included demographics, indications, operative techniques (fenestrating vs. reconstituting), intra-operative findings, and complications.
• Primary endpoint: clinically significant bile leak; secondary endpoints: reoperation, ERCP, readmission, and mortality.

Main Results:

• Laparoscopic STC was performed in 97% of cases.
• Clinically significant bile leak occurred in 2.6% of patients; no reoperations, readmissions, or mortality were recorded.
• One patient (2.6%) required endoscopic retrograde cholangiopancreatography (ERCP).

Conclusions:

• STC provides a safe alternative to total cholecystectomy for complex gallbladder cases.
• Bile leak is a notable morbidity associated with STC.
• Operative technique and intra-operative findings impact outcomes, underscoring the need for standardization and careful case selection.