Akademik Veri Yönetim Sistemi
The World Society of Emergency Surgery Congress 2024, Rodos, Yunanistan, 25 - 28 Haziran 2024, (Yayınlanmadı)
Background:
Subtotal cholecystectomy is a safe bail-out procedure when the critical view of
safety cannot be achieved. Subtotal cholecystectomy can be managed either by a
fenestrating method (without forming a remnant gallbladder) or by
reconstituting method (with forming a gallbladder remnant). The aim of this
study is to compare the results of these two different subtotal cholecystectomy
methods.
Material and Methods: The
records of patients who underwent laparoscopic subtotal cholecystectomy (either
fenestrating or reconstituting) between January 2014- July 2023 were analyzed
retrospectively.
Results: Of
the 53 consecutive patients who underwent laparoscopic subtotal cholecystectomy
2 were converted to open surgery and were excluded from the study. Twenty-two
patients were in fenestrating group (FG) and 29 patients were in the
reconstituting group (RG). Three patients in FG and one patient in RG group
developed a biliary fistula all of which treated conservatively. There was no statistically
significant difference between two groups. Six patients in FG and 9 patients in
RG developed biliary complications requiring endoscopic intervention. Eight
patients in RG received a completion cholecystectomy whilst no patient needed
additional surgery in FG. There was no statistically difference between the two
groups in terms of surgery time, length of stay, and postoperative
complications.
Conclusion: The most effective technique may depend on
the surgeon's experience in handling difficult cholecystectomies, particularly
when achieving the critical view of safety is not possible. Whether the cystic
stump is closed or not does not impact the prevention of bile fistula. However,
the fenestrating method can help avoid the need for completion cholecystectomy
and its associated complications.