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Subtotal Cholecystectomy and Open Total Cholecystectomy: Alternatives in Complicated Cholecystitis
Journal article   Peer reviewed

Subtotal Cholecystectomy and Open Total Cholecystectomy: Alternatives in Complicated Cholecystitis

Daniel Kaplan, Kenji Inaba, Konstantinos Chouliaras, Garren M. I. Low, Elizabeth Benjamin, Lydia Lam, Daniel Grabo and Demetrios Demetriades
The American surgeon, v 80(10), pp 953-955
01 Oct 2014
PMID: 25264637
url
https://doi.org/10.1177/000313481408001009View
Published, Version of Record (VoR) Restricted

Abstract

Life Sciences & Biomedicine Science & Technology Surgery
Subtotal cholecystectomy (SC) is an alternative to open total cholecystectomy (OTC) when variable anatomy or other intraoperative findings preclude safe dissection of Calot's triangle. The objective of this study was to compare the outcomes between SC and OTC in patients with complicated cholecystitis, cases that could not be completed with the original surgical approach and required intraoperative conversion to either SC or OTC. All cases of cholecystectomy converted to SC or OTC from January 2008 to December 2012 were retrospectively identified. Preoperative laboratory values, imaging studies, and clinical demographics were compared between the two groups. The outcome variables analyzed included hospital and intensive care unit length of stay as well as intraoperative complications. In this study, 214 cases of complicated cholecystitis were analyzed; 63 SC and 151 laparoscopic converted to OTC. From the SC group, 46 (73%) were converted to open, 12 (19%) were primary open, and five (8%) were done laparoscopically. There were no statistically significant differences in demographics, preoperative serologic markers, or intraoperative findings (P > 0.05). Five (3.3%) common bile duct (CBD) injuries occurred in the OTC group, whereas none occurred in the SC group. Overall there were 23 (15.2%) complications in the OTC group and nine (14.3%) in the SC group. The aggregate severe complication rate (CBD injury, vascular injury, gastrointestinal injury) was significantly higher in the OTC group (0.0 to 7.9%, P = 0.036). In conclusion, SC may be considered as a safe alternative in complicated cholecystitis.

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Collaboration types
Domestic collaboration
Web of Science research areas
Surgery
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