Subtotal Cholecystectomy for Difficult Gall Bladder Due to Chronic Cholecystitis

Tribhuvan University Teaching Hospital, Institute Of Medicine.1,149 enrolled

Overview

Subtotal cholecystectomy (STC) is a valuable technique when severe inflammation, fibrosis, or anatomical variations obscure the critical view of safety essential for identifying the cystic duct and artery. It helps reduce the risk of bile duct injuries and other complications that arise during a total cholecystectomy (TC) when these structures are not visible. This study evaluates the safety and outcomes of subtotal cholecystectomy in chronic cholecystitis.

A retrospective analysis was conducted in all patients who underwent a cholecystectomy between May 2021 and November 2024. Indications, complications, and perioperative outcomes of STC were compared with those of standard TC. The investigators concluded STC is an important bailout procedure in a difficult laparoscopic cholecystectomy associated with higher early postoperative complications but lower bile duct injury.

Study Type

OBSERVATIONAL

Enrollment

1,149

Conditions

Gallstone

Interventions

cholecystectomyPROCEDURE

The indications for elective cholecystectomy were symptomatic cholelithiasis, a GB polyp more than ten millimeters, a history of cholecystitis, biliary pancreatitis, or choledocholithiasis. Patients with cholecystitis and severe or moderately severe pancreatitis were operated on after six weeks of the event. Other patients received surgery at the earliest available date. All patients with choledocholithiasis underwent endoscopic retrograde cholangiopancreatography (ERCP) and stone clearance before cholecystectomy. Patients who underwent laparoscopic cholecystectomy were evaluated by surgical and anesthesia teams in outpatient clinics and co-morbid conditions were optimized. Preoperative antibiotic prophylaxis was given to all the patients before induction of anesthesia.

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * Clinical diagnosis of cholelithiasis planned for laparoscopic cholecystectomy * Clinical diagnosis of gallbladder polyp planned for laparoscopic cholecystectomy Exclusion Criteria: * Gall bladder malignancy * Cholelithiasis and gallbladder polyp cases managed non-operatively * additional procedures along with cholecystectomy like bile duct exploration, bile duct excision for choledochal cyst.

Locations (1)

Tribhuvan University Teaching Hospital, Kathmandu, Nepal

Kathmandu, Nepal

Outcomes

Primary Outcomes

postoperative outcomes of subtotal cholecystectomy (STC) and total cholecystectomy (TC)

The primary outcome was to assess the postoperative outcomes of subtotal cholecystectomy (STC) and total cholecystectomy (TC) groups.

Time frame: upto 22 months

Data from ClinicalTrials.gov

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