Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis

Hamdy Sedky Abdallah

doi:doi:10.11648/j.js.20170506.15

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Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis

Hamdy Sedky Abdallah

Published in Journal of Surgery (Volume 5, Issue 6)

Received: 29 September 2017 Accepted: 10 October 2017 Published: 12 November 2017

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Abstract

Background: When the critical view of safety (CVS) can't be obtained during dissection of Calot’s triangle in difficult gallbladder, conversion to open surgery or other “damage control” alternatives as cholecystostomy and subtotal cholecystectomy are recommended to prevent bile duct injury. Materials and methods: The medical records of all patients presented with acute calculous cholecystitis (ACC) during the study period were retrospectively reviewed and analyzed. Results: Laparoscopic cholecystectomy (LC) was attempted in 71 difficult gallbladders out of 379 patients presenting with ACC. In 6 patients (8.5%), conversion to open surgery or laparoscopic cholecystostomy was performed. Laparoscopic subtotal cholecystectomy (LSC) with dissection and control of the cystic duct was performed for the remaining 65 patients (91.5%) including 50 females (77%) and 15 males (23%) with a mean age of 42.35±12.4 years. The mean operative blood loss was 45.28±18.6 CC and the mean operative time was 96.3±24.19 minutes. There were no operative complications or mortality. The mean hospital stay was 28±17.8 hours. There was no postoperative jaundice, bile leak, intra-abdominal collections or mortality. Conclusion: When surgery is indicated for difficult ACC, LSC with control of the cystic duct is safe with excellent outcomes. However, if the CVS can’t be achieved due to obscured anatomy at Calot’s triangle, conversion to open surgery or cholecystostomy must be performed to prevent bile duct injury.

Published in	Journal of Surgery (Volume 5, Issue 6)
DOI	10.11648/j.js.20170506.15
Page(s)	111-117
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Subtotal Cholecystectomy, Laparoscopy, Acute Calculous Cholecystitis

References

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APA Style

Hamdy Sedky Abdallah. (2017). Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis. Journal of Surgery, 5(6), 111-117. https://doi.org/10.11648/j.js.20170506.15

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ACS Style

Hamdy Sedky Abdallah. Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis. J. Surg. 2017, 5(6), 111-117. doi: 10.11648/j.js.20170506.15

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AMA Style

Hamdy Sedky Abdallah. Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis. J Surg. 2017;5(6):111-117. doi: 10.11648/j.js.20170506.15

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@article{10.11648/j.js.20170506.15,
  author = {Hamdy Sedky Abdallah},
  title = {Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis},
  journal = {Journal of Surgery},
  volume = {5},
  number = {6},
  pages = {111-117},
  doi = {10.11648/j.js.20170506.15},
  url = {https://doi.org/10.11648/j.js.20170506.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20170506.15},
  abstract = {Background: When the critical view of safety (CVS) can't be obtained during dissection of Calot’s triangle in difficult gallbladder, conversion to open surgery or other “damage control” alternatives as cholecystostomy and subtotal cholecystectomy are recommended to prevent bile duct injury. Materials and methods: The medical records of all patients presented with acute calculous cholecystitis (ACC) during the study period were retrospectively reviewed and analyzed. Results: Laparoscopic cholecystectomy (LC) was attempted in 71 difficult gallbladders out of 379 patients presenting with ACC. In 6 patients (8.5%), conversion to open surgery or laparoscopic cholecystostomy was performed. Laparoscopic subtotal cholecystectomy (LSC) with dissection and control of the cystic duct was performed for the remaining 65 patients (91.5%) including 50 females (77%) and 15 males (23%) with a mean age of 42.35±12.4 years. The mean operative blood loss was 45.28±18.6 CC and the mean operative time was 96.3±24.19 minutes. There were no operative complications or mortality. The mean hospital stay was 28±17.8 hours. There was no postoperative jaundice, bile leak, intra-abdominal collections or mortality. Conclusion: When surgery is indicated for difficult ACC, LSC with control of the cystic duct is safe with excellent outcomes. However, if the CVS can’t be achieved due to obscured anatomy at Calot’s triangle, conversion to open surgery or cholecystostomy must be performed to prevent bile duct injury.},
 year = {2017}
}

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TY - JOUR
T1 - Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis
AU - Hamdy Sedky Abdallah
Y1 - 2017/11/12
PY - 2017
N1 - https://doi.org/10.11648/j.js.20170506.15
DO - 10.11648/j.js.20170506.15
T2 - Journal of Surgery
JF - Journal of Surgery
JO - Journal of Surgery
SP - 111
EP - 117
PB - Science Publishing Group
SN - 2330-0930
UR - https://doi.org/10.11648/j.js.20170506.15
AB - Background: When the critical view of safety (CVS) can't be obtained during dissection of Calot’s triangle in difficult gallbladder, conversion to open surgery or other “damage control” alternatives as cholecystostomy and subtotal cholecystectomy are recommended to prevent bile duct injury. Materials and methods: The medical records of all patients presented with acute calculous cholecystitis (ACC) during the study period were retrospectively reviewed and analyzed. Results: Laparoscopic cholecystectomy (LC) was attempted in 71 difficult gallbladders out of 379 patients presenting with ACC. In 6 patients (8.5%), conversion to open surgery or laparoscopic cholecystostomy was performed. Laparoscopic subtotal cholecystectomy (LSC) with dissection and control of the cystic duct was performed for the remaining 65 patients (91.5%) including 50 females (77%) and 15 males (23%) with a mean age of 42.35±12.4 years. The mean operative blood loss was 45.28±18.6 CC and the mean operative time was 96.3±24.19 minutes. There were no operative complications or mortality. The mean hospital stay was 28±17.8 hours. There was no postoperative jaundice, bile leak, intra-abdominal collections or mortality. Conclusion: When surgery is indicated for difficult ACC, LSC with control of the cystic duct is safe with excellent outcomes. However, if the CVS can’t be achieved due to obscured anatomy at Calot’s triangle, conversion to open surgery or cholecystostomy must be performed to prevent bile duct injury.
VL - 5
IS - 6
ER -

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Author Information

Hamdy Sedky Abdallah

General Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt

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Plain Text BibTeX RIS

APA Style

Hamdy Sedky Abdallah. (2017). Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis. Journal of Surgery, 5(6), 111-117. https://doi.org/10.11648/j.js.20170506.15

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ACS Style

Hamdy Sedky Abdallah. Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis. J. Surg. 2017, 5(6), 111-117. doi: 10.11648/j.js.20170506.15

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AMA Style

Hamdy Sedky Abdallah. Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis. J Surg. 2017;5(6):111-117. doi: 10.11648/j.js.20170506.15

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@article{10.11648/j.js.20170506.15,
  author = {Hamdy Sedky Abdallah},
  title = {Laparoscopic Subtotal Cholecystectomy for Difficult Acute Calculous Cholecystitis},
  journal = {Journal of Surgery},
  volume = {5},
  number = {6},
  pages = {111-117},
  doi = {10.11648/j.js.20170506.15},
  url = {https://doi.org/10.11648/j.js.20170506.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20170506.15},
  abstract = {Background: When the critical view of safety (CVS) can't be obtained during dissection of Calot’s triangle in difficult gallbladder, conversion to open surgery or other “damage control” alternatives as cholecystostomy and subtotal cholecystectomy are recommended to prevent bile duct injury. Materials and methods: The medical records of all patients presented with acute calculous cholecystitis (ACC) during the study period were retrospectively reviewed and analyzed. Results: Laparoscopic cholecystectomy (LC) was attempted in 71 difficult gallbladders out of 379 patients presenting with ACC. In 6 patients (8.5%), conversion to open surgery or laparoscopic cholecystostomy was performed. Laparoscopic subtotal cholecystectomy (LSC) with dissection and control of the cystic duct was performed for the remaining 65 patients (91.5%) including 50 females (77%) and 15 males (23%) with a mean age of 42.35±12.4 years. The mean operative blood loss was 45.28±18.6 CC and the mean operative time was 96.3±24.19 minutes. There were no operative complications or mortality. The mean hospital stay was 28±17.8 hours. There was no postoperative jaundice, bile leak, intra-abdominal collections or mortality. Conclusion: When surgery is indicated for difficult ACC, LSC with control of the cystic duct is safe with excellent outcomes. However, if the CVS can’t be achieved due to obscured anatomy at Calot’s triangle, conversion to open surgery or cholecystostomy must be performed to prevent bile duct injury.},
 year = {2017}
}

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