Evaluation of usefulness of laparoscopic subtotal cholecystectomy in complicated cholecystitis
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 6
Abstract
Background: Laparoscopic Cholecystectomy is made hazardous by distortion of anatomy of calot’s triangle by acute or chronic inflammation. A significant portion of patients with unclear anatomy are still converted to open to complete the procedure. The other option is subtotal cholecystectomy and increasing laparoscopic experiences has made laparoscopic subtotal cholecystectomy a feasible option in patients with complicated acute or chronic cholecystitis. In our study, we tried to evaluate its safety and effectiveness with reference to literatures available. Materials and Methods: This prospective study evaluated all the patients Scheduled for laparoscopic cholecystectomy between January 2012 to December 2014 in our institution. Among them Laparoscopic subtotal cholecystectomy was performed in 74 patients due to various complicated form of cholecystitis. Results: Laparoscopic subtotal cholecystectomy was performed in 74 patients of the total 1039 laparoscopic cholecystectomies. There were 38 males, 36 females with a median age of 60 years. The mean operating time was 80 +/- 12 mins and mean hospital stay was 4+/- 1 days .Twelve patients had postoperative bile leak, which resolved spontaneously in 9 patients and 3 patients required endoscopic retrograde cholangiopancreaticography for extraction of bile duct stones and placement of stent in CBD . There was no bile duct injury and no mortality. We encountered 2 conversions in our series. Conclusion: In a given situation of difficult dissection of calot’s triangle, laparoscopic subtotal cholecystectomy is a safe procedure. The Complications like bile leak is predictable and can be readily managed. It is not a substitute to open conversion if deemed necessary.
Authors and Affiliations
Amaresh Mishra, S K Mohanty, S P Sahoo, C R Behera
Keywords
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