Re-interventions and re-admissions in a 13-year series following use of laparoscopic subtotal cholecystectomy.
Gallbladder
laparoscopic cholecystectomy
laparoscopic subtotal cholecystectomy
subtotal cholecystectomy
Journal
Journal of minimal access surgery
ISSN: 0972-9941
Titre abrégé: J Minim Access Surg
Pays: India
ID NLM: 101228183
Informations de publication
Date de publication:
Historique:
pubmed:
2
10
2019
medline:
2
10
2019
entrez:
2
10
2019
Statut:
ppublish
Résumé
Laparoscopic subtotal cholecystectomy (LSTC) without cystic duct ligation is an alternative to conversion to open surgery in a difficult cholecystectomy, thus avoiding a potentially hazardous dissection in Calot's triangle. The long-term outcomes of this procedure are not well reported. The aim of this study is to assess the rates of re-presentation, re-admissions, endoscopic interventions and completion cholecystectomy in patients who have undergone LSTC. Details of all patients undergoing cholecystectomy over a 13-year period (2003-2015) were entered on a prospective database. Further information on subsequent hospital attendances, biliary imaging, endoscopic interventions and re-operations following the index LSTC was collected retrospectively from hospital database. Overall, 2313 patients underwent laparoscopic cholecystectomy. Eighty-five patients (3.7%) underwent LSTC and the rest had standard laparoscopic cholecystectomy. A controlled bile leak was observed in 16 (19%) patients post-operatively, of which 3 resolved spontaneously. The remaining 13 were managed with an early endoscopic retrograde cholangiopancreatography (ERCP) and biliary stent. Twenty-seven patients (32%), who underwent LSTC, were re-investigated for the upper abdominal symptoms. The time range for re-investigation was 21 days-124 months. Eight patients underwent ERCP post-discharge, for suspected bile duct stones on radiological imaging. Two patients required open completion cholecystectomy for symptomatic stones in the gallbladder remnant. LSTC is a feasible and safe alternative to open surgery with acceptable long-term consequences and re-interventions.
Sections du résumé
BACKGROUND
BACKGROUND
Laparoscopic subtotal cholecystectomy (LSTC) without cystic duct ligation is an alternative to conversion to open surgery in a difficult cholecystectomy, thus avoiding a potentially hazardous dissection in Calot's triangle. The long-term outcomes of this procedure are not well reported. The aim of this study is to assess the rates of re-presentation, re-admissions, endoscopic interventions and completion cholecystectomy in patients who have undergone LSTC.
METHODS
METHODS
Details of all patients undergoing cholecystectomy over a 13-year period (2003-2015) were entered on a prospective database. Further information on subsequent hospital attendances, biliary imaging, endoscopic interventions and re-operations following the index LSTC was collected retrospectively from hospital database.
RESULTS
RESULTS
Overall, 2313 patients underwent laparoscopic cholecystectomy. Eighty-five patients (3.7%) underwent LSTC and the rest had standard laparoscopic cholecystectomy. A controlled bile leak was observed in 16 (19%) patients post-operatively, of which 3 resolved spontaneously. The remaining 13 were managed with an early endoscopic retrograde cholangiopancreatography (ERCP) and biliary stent. Twenty-seven patients (32%), who underwent LSTC, were re-investigated for the upper abdominal symptoms. The time range for re-investigation was 21 days-124 months. Eight patients underwent ERCP post-discharge, for suspected bile duct stones on radiological imaging. Two patients required open completion cholecystectomy for symptomatic stones in the gallbladder remnant.
CONCLUSION
CONCLUSIONS
LSTC is a feasible and safe alternative to open surgery with acceptable long-term consequences and re-interventions.
Identifiants
pubmed: 31571673
pii: 264952
doi: 10.4103/jmas.JMAS_124_19
pmc: PMC7945629
doi:
Types de publication
Journal Article
Langues
eng
Pagination
28-31Déclaration de conflit d'intérêts
None
Références
Am Surg. 2014 Oct;80(10):953-5
pubmed: 25264637
Br J Surg. 2007 Dec;94(12):1527-9
pubmed: 17701938
J Minim Access Surg. 2016 Oct-Dec;12(4):325-9
pubmed: 27251818
Surg Endosc. 2016 Feb;30(2):526-531
pubmed: 26091984
JAMA Surg. 2015 Feb;150(2):159-68
pubmed: 25548894
Surg Endosc. 2003 Sep;17(9):1437-9
pubmed: 12799885
Br J Surg. 1998 Jul;85(7):904-6
pubmed: 9692560
Hernia. 2009 Jun;13(3):275-80
pubmed: 19259615
Surg Today. 2009;39(10):870-5
pubmed: 19784726
Surg Endosc. 2013 Feb;27(2):351-8
pubmed: 22806521
Surg Endosc. 2008 Jul;22(7):1697-700
pubmed: 18071804
Surg Endosc. 1999 Sep;13(9):922-4
pubmed: 10449854
J Am Coll Surg. 2016 Jan;222(1):89-96
pubmed: 26521077
Am Surg. 1998 Oct;64(10):955-7
pubmed: 9764700
Ulus Cerrahi Derg. 2016 Apr 06;32(3):185-90
pubmed: 27528821
J Gastrointest Surg. 2010 Oct;14(10):1619-28
pubmed: 20352368