Journal article
Subtotal Cholecystectomy and Open Total Cholecystectomy: Alternatives in Complicated Cholecystitis
The American surgeon, v 80(10), pp 953-955
01 Oct 2014
PMID: 25264637
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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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Details
- Title
- Subtotal Cholecystectomy and Open Total Cholecystectomy: Alternatives in Complicated Cholecystitis
- Creators
- Daniel Kaplan - LAC+USC Medical CenterKenji Inaba - University of Southern CaliforniaKonstantinos Chouliaras - University of Southern CaliforniaGarren M. I. Low - LAC+USC Medical CenterElizabeth Benjamin - University of Southern CaliforniaLydia Lam - LAC+USC Medical CenterDaniel Grabo - LAC+USC Medical CenterDemetrios Demetriades - LAC (Czechia)
- Publication Details
- The American surgeon, v 80(10), pp 953-955
- Publisher
- Southeastern Surgical Congress
- Number of pages
- 3
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Otolaryngology (and Head and Neck Surgery)
- Web of Science ID
- WOS:000342277900009
- Scopus ID
- 2-s2.0-84921776147
- Other Identifier
- 991022008190604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery