Minimally invasive subtotal cholecystectomy. What surgeons need to know.
Bailout Strategy
Bile duct injury
Laparoscopic cholecystectomy
Subtotal cholecystectomy
Journal
Updates in surgery
ISSN: 2038-3312
Titre abrégé: Updates Surg
Pays: Italy
ID NLM: 101539818
Informations de publication
Date de publication:
12 Sep 2024
12 Sep 2024
Historique:
received:
01
06
2024
accepted:
05
09
2024
medline:
12
9
2024
pubmed:
12
9
2024
entrez:
12
9
2024
Statut:
aheadofprint
Résumé
Minimally invasive laparoscopic cholecystectomy is among the most frequently performed abdominal surgeries. Bile duct injury is a significative complication that occurs in about 0.2-0.3% of open procedures and 0.5% of laparoscopic surgeries, with concomitant vasculobiliary injuries in 12-61% of cases. Most of these lesions occurs during challenging severe cholecystitis where the intense inflammation obscures the hepatocystic anatomy. In this case a bailout strategy such as a subtotal cholecystectomy should be considered. Subtotal cholecystectomy is a surgical technique performed to remove a portion of the gallbladder while leaving part of it behind. In such complex cholecystectomies, surgeons should be aware of this technique, and subtotal cholecystectomy should be part of their surgical armamentarium. We aim to familiarize surgeons with bailout techniques like subtotal cholecystectomy and gallbladder emptying for challenging acute cholecystectomy cases to reduce the risk of vasculobiliary injury. This multimedia article provides, a comprehensive step-by-step overview of the different possible minimally invasive subtotal cholecystectomy procedures, we outline five distinct techniques for conducting subtotal cholecystectomy, including some tips and tricks and demonstrates the usefulness of a minimally invasive approach. Finally, we emphasize the importance of carefully choosing between laparoscopic and robotic approaches and suggests using adjunctive tools, such as preoperative indocyanine green, to better identify common bile duct anatomy.
Identifiants
pubmed: 39264469
doi: 10.1007/s13304-024-01995-0
pii: 10.1007/s13304-024-01995-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. Italian Society of Surgery (SIC).
Références
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