Subtotal cholecystectomy in acute cholecystitis

Subtotal cholecystectomy for the hostile gallbladder: failure to control the cystic duct results in significant morbidity

“…The technical challenges of operating on a severely diseased gallbladder are not unfamiliar amongst surgeons, where a hostile triangle of Calot fails to show its anatomy, and the inflammation prevents safe dissection and identification of the cystic duct in relationship to the portal structures. First reported in 1955 by Madding et al, 25 subtotal cholecystectomy is a technique to avoid common bile duct injury, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][20][21][22] and is described simply as the removal of only a portion of the gallbladder when inflammation precludes safe dissection and transection of the cystic duct. 12,23 Unfortunately, the current body of literature reports at least three major surgical techniques for subtotal cholecystectomy (Table 5), making it challenging to interpret this data.…”

Resultados asociados con la realización de colecistectomía subtotal en un hospital de tercer nivel de Bogotá

“…La colecistectomía subtotal fue primero reportada por Madding en 1955 13 para reemplazar la colecistostomía y como un procedimiento de rescate en casos donde la colecistectomía total era técnicamente difícil. Con la introducción de la colecistectomía laparoscópica por Muhe y Mouret 14 , esta se ha vuelto el procedimiento de elección por los resultados asociados 15 .…”

Use of a piece of free omentum to prevent bile leakage after subtotal cholecystectomy

“…Madding 16 first reported SC in 1955 as an alternative for conventional total cholecystectomy as a rescue procedure in cases of a technically difficult total cholecystectomy that minimized the potential for injury to the bile duct and vascular structures when they were severely inflamed. SC was performed by piecemeal excision of the gallbladder, transecting the gallbladder neck or Hartmann's pouch, and leaving a rim of the posterior wall attached to the liver bed.…”