Safety of laparoscopic subtotal cholecystectomy in acute cholecystitis. Experience in Southeast Mexico

Roesch-Dietlen, F.; Pérez-Morales, Alfonso Gerardo; Martínez-Fernández, Silvia; Díaz-Roesch, F.; Gómez-Delgado, J.A.; Remes-Troche, J.M.

doi:10.1016/j.rgmxen.2018.11.007

Cited by 7 publications

(9 citation statements)

References 15 publications

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“…De acuerdo con el estudio de Roesch-Dietlen y colaboradores, los factores de riesgo más importantes de colecistectomía difícil resuelta por colecistectomía subtotal reconstituida fueron obesidad en 28% (p = 0.185) sin especificar grado y DM2 en 15% (p = 0.084). 27 A pesar de que ambas comorbilidades se observan con mayor frecuencia en colecistectomías difíciles, no se encuentra una diferencia estadísticamente significativa en la influencia de realizar una colecistectomía subtotal. En realidad, los factores de riesgo prequirúrgicos ofrecen poca utilidad para tomar la decisión de efectuar una colecistectomía subtotal.…”

Section: Discussionunclassified

“…Madni y colaboradores proponen la escala de Parkland para clasificar el grado de colecistitis con base en el primer vistazo laparoscópico una vez introducidos los cuatro trocares, la cual demuestra correlación positiva con el reporte de patología, tiempo operatorio, proporción de conversión, días de estancia hospitalaria y fuga biliar, esta última sólo con el grado V. 27 No se evaluó la tasa de colecistectomías subtotales, www.medigraphic.org.mx ni si al convertir la cirugía se logró una colecistectomía total; sin embargo, resulta interesante la proposición de una escala transquirúrgica previa al intento de disección que unifique las definiciones, ya que actualmente el punto de inflexión es subjetivo al propio cirujano o a quien lo asista. Se requieren más estudios y validación para esta escala en el contexto del uso en colecistectomía subtotal.…”

Section: Discussionunclassified

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Colecistectomía subtotal como opción de manejo para colecistectomía difícil

Centeno¹,

Magaña²,

Barba³

et al. 2021

Cirujano General

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Section: Discussionunclassified

Colecistectomía subtotal como opción de manejo para colecistectomía difícil

Centeno¹,

Magaña²,

Barba³

et al. 2021

Cirujano General

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“…Some authors published results on the superiority of subtotal cholecystectomy in prevention of bile duct injury (16). Conversion also decreased with the gaining of experience.…”

Section: Discussionmentioning

confidence: 99%

The impact of surgical experience on complications of laparoscopic cholecystectomy

Мамакеев¹,

Zhortuchiev²,

Beyshenaliev³

et al. 2020

HVT

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Objective: Laparoscopic cholecystectomy (LC) is the gold standard option for the surgical treatment of cholecystitis. Meanwhile, experience of surgical center and operator play central role in adequate management of patients with gallbladder disorders. The aim of this study is to analyze complications and conversion rates of laparoscopic cholecystectomy at various periods of implication of the method in a single center. Methods: We retrospectively analyzed early complications of 6381 patients operated due to various forms of cholecystitis according to periods of implication of LC in Kyrgyz National Center of General Surgery . Patients were divided into 3 groups: first group of patients were operated from 1996 to 2004 during first implementation of technique (n=1446); second group patients underwent operation between 2005-2008, when operators concentrated on technical skills (n=1225); third group of patients operated between 2009 and 2019, when surgical team concentrated on prevention of complications. Results: Both complication and conversion cases represented strong association with surgical experience. The highest complications (4.8% vs 1.5% and 0.4%, respectively, p<0.001) and conversion to surgical cholecystectomy (11.2% vs 1.5% and 0.1%, respectively, p=0.001) rates were detected in group 1 as compared to groups 2 and 3. Conclusion: Occurrence of complications and conversion to conventional surgical cholecystectomy reduced over time, depending on surgical experience of operating team and practice of operator.

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“…The quality of evidence was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group Criteria. 20 The quality of evidence was high to moderate in five studies 13,15,16,18,19 and low in two studies 14,17 (Supplementary file: eTable 2). The risk of bias was evaluated using the Joanna Briggs Institute (JBI) critical appraisal checklist for observational studies (Supplementary file: eTable 3).…”

Section: Methodsmentioning

confidence: 99%

“…Complicated acute cholecystitis was defined by the presence of pericholecystic adhesions, empyema, gangrene, perforation, or severe inflammation. [13][14][15][16][17][18][19] Data Collection…”

Section: Study Selection and Eligibility Criteriamentioning

confidence: 99%

Evaluating Clinical Outcomes of Laparoscopic Subtotal and Total Cholecystectomy for Complicated Acute Cholecystitis: A Systematic Review and Meta-Analysis

Martinez,

Breeding,

Katz

et al. 2023

The American Surgeon™

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Introduction This systematic review and meta-analysis aimed to compare clinical outcomes in patients with complicated acute cholecystitis undergoing laparoscopic total vs subtotal cholecystectomy. Methods This systematic review and meta-analysis was conducted according to PRISMA guidelines and queried PubMed, Embase, ProQuest, Google Scholar, and Cochrane databases from inception to May 2023. The primary outcome was complication rates including common bile duct injury, wound infection, reoperation, bile leak, retained stones, and subhepatic collection, whereas secondary outcomes were in-hospital mortality and hospital length of stay. Results A total of 7 studies with 135,233 cases were included for meta-analysis. Patients who underwent laparoscopic total cholecystectomy had a significantly lower risk of postoperative bile leaks (RR: .15; 95% CI: .03, .80) and subhepatic fluid collection (RR: 0.19; 95% CI: .06, .63) and were 2.94 times less likely to die compared to those who underwent subtotal cholecystectomy (RR .34; 95% CI: .15, .77). Patients who underwent subtotal cholecystectomy had significantly longer hospital length of stay (mean difference 1.0 days; 95% CI: .5 days, 1.4 days). Conclusions In adult patients presenting with complicated cholecystitis, management with laparoscopic subtotal cholecystectomy presents a unique complication profile with increased risk of postoperative bile leak and subhepatic fluid collection, in-hospital mortality, and longer hospital length-of-stay when used as an alternative approach to laparoscopic total cholecystectomy. Further research into the most appropriate clinical scenarios and patient populations for the use of the subtotal cholecystectomy approach may prove useful in improving its associated outcomes.

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Safety of laparoscopic subtotal cholecystectomy in acute cholecystitis. Experience in Southeast Mexico

Cited by 7 publications

References 15 publications

Colecistectomía subtotal como opción de manejo para colecistectomía difícil

Colecistectomía subtotal como opción de manejo para colecistectomía difícil

The impact of surgical experience on complications of laparoscopic cholecystectomy

Evaluating Clinical Outcomes of Laparoscopic Subtotal and Total Cholecystectomy for Complicated Acute Cholecystitis: A Systematic Review and Meta-Analysis

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