Fundus-First Laparoscopic Cholecystectomy in Difficult Gallbladders: A Safe Alternative Technique

KANAN ISMAYILZADA, MD124 enrolled

Overview

This retrospective cross-sectional study evaluated the safety and effectiveness of the fundus-first laparoscopic cholecystectomy (FFLC) technique in patients with difficult gallbladders. A total of 124 patients who underwent FFLC between 2023 and 2024 were reviewed. The study assessed operative time, intraoperative complications, conversion rates, and postoperative outcomes. The results suggest that FFLC is a safe and feasible approach that can reduce the need for conversion to open surgery in complex cases. The study was conducted at a private hospital in Istanbul, Turkey

This retrospective study was conducted at a private healthcare institution without a formal IRB. All patient data were anonymised before analysis, and written informed consent was obtained from all patients for the academic use of their clinical data

Study Type

OBSERVATIONAL

Enrollment

124

Conditions

Cholelithiasis

Interventions

Conventional Laparoscopic CholecystectomyPROCEDURE

Standard laparoscopic cholecystectomy technique starting at Calot's triangle. Used as the comparator group in this study.

Fundus-First Laparoscopic CholecystectomyPROCEDURE

Laparoscopic cholecystectomy technique initiated at the gallbladder fundus and carried out retrogradely toward Calot's triangle. This method was applied to difficult gallbladders (Nassar Grade 3-4) to improve operative safety and avoid conversion to open surgery.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients who underwent laparoscopic cholecystectomy at the study center between January 2023 and March 2024 * Patients diagnosed with difficult gallbladder (Nassar Grade 3-4) * Age ≥ 18 years * Complete clinical data available for analysis Exclusion Criteria: * Patients with incomplete medical records * Patients undergoing open cholecystectomy from the beginning * Patients under 18 years of age

Locations (1)

Medicana Ataşehir International Hospital

Istanbul, Ataşehir, Turkey (Türkiye)

Outcomes

Primary Outcomes

Conversion Rate to Open Surgery

Rate of conversion from laparoscopic to open cholecystectomy in each group. Measured as number and percentage of patients converted.

Time frame: Intraoperative (during surgery)

Secondary Outcomes

Operative Time

Total operative time measured in minutes from skin incision to closure. Comparison between the fundus-first and conventional laparoscopic cholecystectomy groups.

Time frame: Intraoperative (during surgery)

Postoperative Complication Rate

Includes complications such as wound infection, bile leak, abscess, or any adverse event requiring medical or surgical intervention. Compared between groups

Time frame: Within 30 days postoperatively

Length of Hospital Stay

Number of days from surgery to discharge. Mean values will be compared between groups.

Time frame: Postoperative hospitalization

Data from ClinicalTrials.gov

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