Subtotal cholecystectomy for difficult acute cholecystitis: how to finalize safely by laparoscopy-a systematic review.
Clavien–Dindo classification
Complications
Difficulty cholecystectomy
Gallbladder
Laparoscopic subtotal cholecystectomy
Journal
World journal of emergency surgery : WJES
ISSN: 1749-7922
Titre abrégé: World J Emerg Surg
Pays: England
ID NLM: 101266603
Informations de publication
Date de publication:
08 09 2021
08 09 2021
Historique:
received:
11
06
2021
accepted:
28
08
2021
entrez:
9
9
2021
pubmed:
10
9
2021
medline:
30
9
2021
Statut:
epublish
Résumé
Aim of this study was to clarify the best laparoscopic subtotal cholecystectomy (LSTC) technique for finalizing a difficult cholecystectomy. A review was performed (1987-2021) searching "difficulty cholecystectomy" AND/OR "subtotal cholecystectomy". The LSTC techniques considered were as follows: type A, leaving posterior wall attached to the liver and the remainder of the gallbladder stump open; type B, like type A but with the stump closed; type C, resection of both the anterior and posterior gallbladder walls and the stump closed; type D, like type C but with the stump open. Morbidity (including mortality) was analysed with Dindo-Clavien classification. Nineteen articles were included. Of the 13,340 patients screened, 678 (8.2%) had cholecystectomy finalized by LSTC: 346 patients (51.0%) had type A LSTC, 134 patients (19.8%) had type B LSTC, 198 patients (29.2%) had type C LSTC, and 198 patients (0%) had type D LSTC. Bile leakage was found in 83 patients (12.2%), and recorded in 58 patients (69.9%) treated by type A. Twenty-three patients (3.4%) developed a subhepatic collection, 19 of whom (82.6%) were treated by type A. Other complications were reported in 72 patients (10.6%). The Dindo-Clavien classification was four for grade I, 27 for grade II, 126 for grade IIIa, 18 for grade IIIb, zero for grade IV and three for grade V. In the case of LSTC, closure of the gallbladder stump represents the best method to avoid complications. Careful exploration of the gallbladder stump is mandatory, washing the abdominal cavity and leaving drainage.
Sections du résumé
BACKGROUND
Aim of this study was to clarify the best laparoscopic subtotal cholecystectomy (LSTC) technique for finalizing a difficult cholecystectomy.
PATIENTS AND METHODS
A review was performed (1987-2021) searching "difficulty cholecystectomy" AND/OR "subtotal cholecystectomy". The LSTC techniques considered were as follows: type A, leaving posterior wall attached to the liver and the remainder of the gallbladder stump open; type B, like type A but with the stump closed; type C, resection of both the anterior and posterior gallbladder walls and the stump closed; type D, like type C but with the stump open. Morbidity (including mortality) was analysed with Dindo-Clavien classification.
RESULTS
Nineteen articles were included. Of the 13,340 patients screened, 678 (8.2%) had cholecystectomy finalized by LSTC: 346 patients (51.0%) had type A LSTC, 134 patients (19.8%) had type B LSTC, 198 patients (29.2%) had type C LSTC, and 198 patients (0%) had type D LSTC. Bile leakage was found in 83 patients (12.2%), and recorded in 58 patients (69.9%) treated by type A. Twenty-three patients (3.4%) developed a subhepatic collection, 19 of whom (82.6%) were treated by type A. Other complications were reported in 72 patients (10.6%). The Dindo-Clavien classification was four for grade I, 27 for grade II, 126 for grade IIIa, 18 for grade IIIb, zero for grade IV and three for grade V.
CONCLUSION
In the case of LSTC, closure of the gallbladder stump represents the best method to avoid complications. Careful exploration of the gallbladder stump is mandatory, washing the abdominal cavity and leaving drainage.
Identifiants
pubmed: 34496916
doi: 10.1186/s13017-021-00392-x
pii: 10.1186/s13017-021-00392-x
pmc: PMC8424983
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
45Informations de copyright
© 2021. The Author(s).
Références
J Hepatobiliary Pancreat Sci. 2013 Jan;20(1):8-23
pubmed: 23307004
Clin Gastroenterol Hepatol. 2006 Mar;4(3):381-6
pubmed: 16527703
Surgery. 1985 Jul;98(1):1-6
pubmed: 3892743
Surg Endosc. 2020 Nov 30;:
pubmed: 33258035
Surg Endosc. 2003 Sep;17(9):1437-9
pubmed: 12799885
Surg Today. 2014 Mar;44(3):462-5
pubmed: 23736889
Surg Endosc. 2013 Feb;27(2):351-8
pubmed: 22806521
Surg Endosc. 2008 Jul;22(7):1697-700
pubmed: 18071804
Ulus Cerrahi Derg. 2016 Apr 06;32(3):185-90
pubmed: 27528821
Am J Surg. 2008 Jan;195(1):108-14
pubmed: 18082551
Surg Endosc. 2021 Feb 2;:
pubmed: 33528666
Surg Endosc. 2008 Dec;22(12):2720-3
pubmed: 18389315
J Am Coll Surg. 2009 Jan;208(1):e1-4
pubmed: 19228492
Ann Surg Treat Res. 2016 Nov;91(5):226-232
pubmed: 27847794
BMJ. 2009 Jul 21;339:b2700
pubmed: 19622552
J Am Coll Surg. 2010 Jul;211(1):132-8
pubmed: 20610259
Surgery. 2020 Mar;167(3):569-574
pubmed: 31879089
Ann Med Surg (Lond). 2017 May 25;19:19-22
pubmed: 28603611
Korean J Hepatobiliary Pancreat Surg. 2011 Nov;15(4):225-30
pubmed: 26421043
J Laparoendosc Adv Surg Tech A. 2000 Feb;10(1):31-4
pubmed: 10706300
Arq Bras Cir Dig. 2018 Jun 21;31(1):e1347
pubmed: 29947681
J Am Coll Surg. 1995 Jan;180(1):101-25
pubmed: 8000648
Br J Surg. 2007 Dec;94(12):1527-9
pubmed: 17701938
Surg Endosc. 2010 Oct;24(10):2626-32
pubmed: 20336321
Surgery. 2021 Apr;169(4):859-867
pubmed: 33478756
J Minim Access Surg. 2016 Oct-Dec;12(4):325-9
pubmed: 27251818
Surg Endosc. 2014 Jun;28(6):1838-43
pubmed: 24414461
Asian J Endosc Surg. 2018 Aug;11(3):206-211
pubmed: 29235252
J Am Coll Surg. 2017 Sep;225(3):371-379
pubmed: 28606484
ScientificWorldJournal. 2013 Nov 06;2013:254287
pubmed: 24319350
Br J Surg. 1997 Sep;84(9):1253-4
pubmed: 9313706
World J Emerg Surg. 2015 Mar 08;10:14
pubmed: 25870652
J Am Coll Surg. 2016 Jan;222(1):89-96
pubmed: 26521077
Am Surg. 1998 Oct;64(10):955-7
pubmed: 9764700
J Hepatobiliary Pancreat Sci. 2010 Sep;17(5):590-4
pubmed: 19844652
World J Surg. 2009 Mar;33(3):520-5
pubmed: 19148698
Am Surg. 1990 Dec;56(12):792-5
pubmed: 2148466
J Minim Access Surg. 2021 Jan-Mar;17(1):28-31
pubmed: 31571673
Am Surg. 1997 Feb;63(2):150-6
pubmed: 9012429
J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):96-100
pubmed: 29090868
J Surg Res. 2017 Aug;216:143-148
pubmed: 28807199
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
Turk J Surg. 2017 Mar 01;33(1):37-39
pubmed: 28589185
Surg Endosc. 2021 May;35(5):2206-2210
pubmed: 32394176
Can Med Assoc J. 1950 Jul;63(1):54-6
pubmed: 15427045
Can J Surg. 2019 Dec 01;62(6):402-411
pubmed: 31782296
Br J Surg. 1998 Jul;85(7):904-6
pubmed: 9692560
HPB Surg. 1996;9(3):133-6
pubmed: 8725451
JAMA. 2003 Apr 2;289(13):1639-44
pubmed: 12672731
Surgery. 2019 Oct;166(4):698-702
pubmed: 31439402
Asian J Endosc Surg. 2020 Apr;13(2):195-199
pubmed: 31074126
J Am Coll Surg. 2005 Oct;201(4):604-11
pubmed: 16183501
Trop Gastroenterol. 1996 Jan-Mar;17(1):49-52
pubmed: 8693586
Am J Surg. 2009 Jun;197(6):781-4
pubmed: 18926519
Surgery. 2018 Sep;164(3):419-423
pubmed: 29887421
Endosc Int Open. 2020 Dec;8(12):E1895-E1899
pubmed: 33269326