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Subtotal cholecystectomy: early and long-term outcomes

  • Wee Ming TayEmail author
  • Ying Jie Toh
  • Vishalkumar G. Shelat
  • Cheong Wei Huey
  • Sameer P. Junnarkar
  • Winston Woon
  • Jee Keem Low
Article

Abstract

Background

In difficult gallbladders, partial or subtotal cholecystectomy (SC) has been described as a reasonable procedure with safe outcomes. Our aim was to look at our data on SC with respect to safety, morbidity and long-term outcome.

Methods

A retrospective analysis was performed for 3560 patients undergoing cholecystectomy from January 2010 to June 2016. For patients who underwent SC, demographics, intra-operative and follow-up details were analysed.

Results

A total of 168 SC patients were included. 102 (60.7%) were male while 66 (39.3%) were female. The median age was 63 years (31-87). These patients were on follow-up for a median of 29 months (1.7-80). 153 were attempted laparoscopically and there were 25 (16.3%) patients which had open conversion. The rest of the 15 patients had open SC. Mean operative time 150 min (70–315) and average blood loss was 170 ml (50–1500). Median length of stay for these patients was 4 days (1–68). There were no common bile duct (CBD) injuries. We had 12 (7.1%) post-operative collections, 4 (2.4%) wound infections, 1 (0.6%) bile leak and 7 (4.2%) retained stones. Post-operative endoscopic retrograde cholangiopancreatography (ERCP) was performed on 4 (2.4%) patients with successful retrieval of CBD stones. One patient has spontaneous passage of CBD stone. The rest of the two patients with very small retained stones in remnant gallbladder were successfully managed conservatively. There was no 30-day or operation-related mortality. No patient required a second operation.

Conclusions

SC is safe and feasible when encountering a difficult gallbladder.

Keywords

Subtotal Cholecystitis Difficult gallbladder 

Notes

Compliance with ethical standards

Disclosures

Drs. Tay, Toh, Shelat, Huey, Junnarkar, Woon and Low have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of General SurgeryTan Tock Seng HospitalSingaporeSingapore
  2. 2.Hepatic, Pancreatic and Biliary (HPB) Surgery Unit, Department of General SurgeryTan Tock Seng HospitalSingaporeSingapore

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