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Subtotal Cholecystectomy: Results of a Single-Center, Registry-Based Retrospective Cohort Study of 180 Adults in 2011-2018.
- Source :
-
Journal of Laparoendoscopic & Advanced Surgical Techniques . Sep2021, Vol. 31 Issue 9, p1019-1033. 15p. - Publication Year :
- 2021
-
Abstract
- Introduction: Data on subtotal cholecystectomy (STC) as an alternative to conventional cholecystectomy in difficult surgical situations are limited. This multiaspectual report aims to reduce the STC-specific knowledge gap and inform clinical decision-making strategies. Materials and Methods: All 180 patients who underwent STC at a single center between 2011 and 2017 were assessed in this retrospective cohort study. Their outcomes were followed up until March 23, 2018. Six subgroups stratified by surgical setting (elective/nonelective), surgical approach used (open/laparoscopic), and type of STC (reconstituting/fenestrating) were compared. Results: The ratio of conventional to STC procedures was 13:1. Of the 180 patients, 150 had a history of hospitalization for the acute biliary disease. The proportion of all cholecystectomies that were STC ranged from 1% to 71% between individual surgeons; similarly, laparoscopic STC comprised 0%-97% of all STCs. STC was associated with high intraoperative (n = 19; 10.6%) and short-term postoperative (n = 159; 88.3%) complication rates. There were three significant intraoperative complications-bleeding (n = 8; 4.4%), bile duct injury (n = 7; 3.9%), and intestinal injury (n = 4; 2.2%). The most common postoperative surgical site complications were external bile leak (21%), wound infection (17%), and biloma (10%). Associations between fenestrating STC and the rates of postoperative bile leak and retained gallstones, mainly in the main bile duct, were detected. Conclusions: STC-associated perioperative morbidity is significant. There is a substantial investigation burden. Injuries can be avoided when conversion to STC is timely, and its technical variant is correctly selected. The STC rate is a potential key performance indicator monitoring gallbladder surgery practice. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10926429
- Volume :
- 31
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Journal of Laparoendoscopic & Advanced Surgical Techniques
- Publication Type :
- Academic Journal
- Accession number :
- 152459333
- Full Text :
- https://doi.org/10.1089/lap.2020.0713