Laparoscopic subtotal cholecystectomy without cystic duct ligation

Sinha, I; Smith, Max L.; Safranek, Peter; Dehn, T. C. B.; Booth, Michael

doi:10.1002/bjs.5889

Cited by 58 publications

(53 citation statements)

References 4 publications

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“…Subtotal cholecystectomy has been recommended as a safe and viable option in patients where anatomical distortion at Calot's triangle precludes a safe dissection [7,8,[13][14][15]. Conversion rate to open surgery is higher for patients with acute cholecystitis than in those without acute cholecystitis.…”

Section: Discussionmentioning

confidence: 99%

Residual gallstone disease — Laparoscopic management

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Residual gallstone disease — Laparoscopic management

et al. 2010

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“…These essentials include the clearance of the Calot's triangle from adipose and fibrous tissue, detachment of the lowest part of the gallbladder from the GB bed and identification of the cystic duct and cystic artery going into the gallbladder (Figure 2) [69]. Alternatively, when the surgeon encounters severe inflammatory or desmoplastic reaction in the Calot's triangle laparoscopic subtotal cholecystectomy can be performed [70][71][72].…”

Section: Intraoperative Patient-related Risk Factorsmentioning

confidence: 99%

Risk Factors and Predictive Models for Conversion of Laparoscopic Cholecystectomy to Open Surgery, and Surgical Quality Outcome Measures

Beliaev¹,

Booth²

2016

Actual Problems of Emergency Abdominal Surgery

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Background: Laparoscopic cholecystectomy is the preferred surgical operation for symptomatic gallstone disease. Conversion of laparoscopic cholecystectomy to open surgery is used to prevent intra-abdominal organ injury, for open common bile duct exploration and to repair intra-abdominal organ injury. Objective:The objective of this chapter is to review risk factors and predictive models for conversion of laparoscopic cholecystectomy to open surgery, and surgical quality outcome measures. Methods:A narrative literature review using Pubmed, Medline, Cochrane library databases and Google search engine is described.Results: From the literature review, patient-and surgeon-related risk factors and predictive models for conversion of laparoscopic cholecystectomy to open surgery were identified. Patient-dependent risk factors included preoperative and intraoperative variables. Current conversion of laparoscopic cholecystectomy to open surgery predictive models use only patient-dependent risk factors and were not tested on an independent sample of patients. Surgical quality outcome measures incorporate an association between conversion and intra-abdominal organ injury that demonstrates that conversion was used as an emergency strategy to repair injuries rather than a safety measure. Conclusion:Conversion of laparoscopic cholecystectomy to open surgery risk stratification based on patient-and surgeon-dependent variables may allow a better management of the patient to keep conversion at low rates and to maintain benefits of minimally invasive surgery.

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“…Furthermore, a dissection that is difficult laparoscopically can be equally difficult during open surgery, and conversion does not guarantee that inadvertent biliary or vascular injuries will be avoided (15). We did not encounter intraoperative major bile duct injury or bleeding in any of our patients who underwent conversion to open surgery.…”

Section: Discussionmentioning

confidence: 92%

“…Some authors have reported that laparoscopic subtotal cholecystectomy (LSC) has been used as an alternative to conversion to open surgery in difficult LCs (2,(15)(16)(17). It has been shown that LSC prevented bile duct injury and decreased conversion rates in selected patients (2,(15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%