Laparoscopic subtotal cholecystectomy for severe cholecystitis

Beldi, Guido; Glättli, A

doi:10.1007/s00464-002-9128-8

Cited by 94 publications

(96 citation statements)

References 11 publications

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“…Subtotal cholecystectomy has been reported as a good alternative to classic cholecystectomy to reduce the risk of BDI and conversion in patients with technically difficult operation for severe cholecystitis [23][24][25][26][27]. Surprisingly, in the current series, subtotal cholecystectomy was performed in only 2.7% of patients.…”

Section: Discussionmentioning

confidence: 55%

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Surgical management of acute cholecystitis: results of a 2-year prospective multicenter survey in Belgium

Navez

Ungureanu²,

Michiels³

et al. 2012

Surg Endosc

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Background Laparoscopic cholecystectomy is considered nowadays as the standard management of acute cholecystitis (AC). However, results from multicentric studies in the general surgical community are still lacking. Methods A prospective multicenter survey of surgical management of AC patients was conducted over a 2-year period in Belgium. Operative features and patients' clinical outcome were recorded. The impact of independent predictive factors on the choice of surgical approach, the risk of conversion, and the occurrence of postoperative complications was studied by multivariate logistic regression analysis.

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Section: Discussionmentioning

confidence: 55%

“…The mortality rate was significantly higher in the primary open approach but not in the converted group. Practically, AC remains a severe and potentially lethal disease [27,29], especially in elderly and high-risk patients.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of acute cholecystitis: results of a 2-year prospective multicenter survey in Belgium

Navez

Ungureanu²,

Michiels³

et al. 2012

Surg Endosc

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“…Open subtotal cholecystectomy has been used safely in patients at high-risk of bile duct injury due to disruption of natural anatomy due to severe fibrosis and inflammation (8). With improvements in laparoscopic techniques, laparoscopic partial cholecystectomy (LPC) has become an effective and safe method of decreasing the rates of conversion to open surgery (9,10).…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Kulen¹,

Tıhan²,

Duman³

et al. 2016

UCD

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Objective: Laparoscopic cholecystectomy has become the ''gold standard'' for benign gallbladder diseases due to its advantages. In the presence of inflammation or fibrosis, the risk of bleeding and bile duct injury is increased during dissection. Laparoscopic partial cholecystectomy (LPC) is a feasible and safe method to prevent bile duct injuries and decrease the conversion (to open cholecystectomy) rates in difficult cholecystectomies where anatomical structures could not be demonstrated clearly. Material and Methods:The feasibility, efficiency, and safety of LPC were investigated. The data of 80 patients with cholelithiasis who underwent LPC (n=40) and conversion cholecystectomy (CC) (n=40) were retrospectively examined. Demographic characteristics, ASA scores, operating time, drain usage, requirement for intensive care, postoperative length of hospital stay, surgical site infection, antibiotic requirement and complication rates were compared. Results:The median ASA value was 1 in the CC group and 2 in the LPC group. Mean operation time was 123 minutes in the CC group, and 87.50 minutes in the LPC group. Surgical drains were used in 16 CC patients and 4 LPC patients. There was no significant difference between groups in postoperative length of intensive care unit stay (p=0.241). When surgical site infections were compared, the difference was at the limit of statistical significance (p=0.055). Early complication rates were not different (p=0.608) but none of the patients in the LPC group suffered from late complications. Conclusion:LPC is an efficient and safe way to decrease the conversion rate. LPC seems to be an alternative procedure to CC with advantages of shorter operating time, lower rates of surgical site infection, shorter postoperative hospitalization and fewer complications in high-risk patients.

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“…They claim that conversion does not guarantee the avoidance of inadvertent biliary or vascular injury. 29 …”

Section: 21mentioning

confidence: 99%

Prevention of Common Bile Duct Injuries in Laparoscopic Cholecystectomy

Malla¹

2012

WJOLS

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Despite advancement in training and technology since its introduction, more than 20 years ago, bile duct injuries continue to be two to three times more common than in open surgery causing significant morbidity and mortality. Hence, a review of the literature present on the internet on bile duct injuries in laparoscopic cholecystectomy was performed to review the causes of biliary injury and methods of prevention of such mishaps. There was a general consensus that careful dissection and correct interpretation of the anatomy avoids the complication of bile duct injury during cholecystectomy. Routine intraoperative cholangiography is associated with a lower incidence and early recognition of bile duct injury. A low threshold to conversion to open approach in case of uncertainty was also advocated.

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Laparoscopic subtotal cholecystectomy for severe cholecystitis

Abstract: Laparoscopic subtotal cholecystectomy for acute cholecystitis offers a simple and safe solution that prevents bile duct injuries and decreases the rate of conversion in anatomically difficult situations.

Cited by 94 publications

References 11 publications

Surgical management of acute cholecystitis: results of a 2-year prospective multicenter survey in Belgium

Surgical management of acute cholecystitis: results of a 2-year prospective multicenter survey in Belgium

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Prevention of Common Bile Duct Injuries in Laparoscopic Cholecystectomy

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