TY - JOUR
T1 - State of the art in subtotal cholecystectomy
T2 - An overview
AU - Ramírez-Giraldo, Camilo
AU - Torres-Cuellar, Andrés
AU - Van-Londoño, Isabella
N1 - © 2023 Ramírez-Giraldo, Torres-Cuellar and Van-Londoño.
Funding Information:
We would like to thank Paula Andrea Fino-Velásquez for the figures.
Publisher Copyright:
2023 Ramírez-Giraldo, Torres-Cuellar and Van-Londoño.
PY - 2023
Y1 - 2023
N2 - INTRODUCTION: Subtotal cholecystectomy is a type of surgical bail-out procedure indicated when facing difficult laparoscopic cholecystectomy due to not reaching the critical view of safety, inadequate identification of the anatomical structures involved and/or risk of injury.MATERIALS AND METHODS: A comprehensive search on PubMed were performed using the following Mesh terms: Subtotal cholecystectomy and Partial cholecystectomy. The PubMed databases were used to search for English-language reports related to Subtotal cholecystectomy between January 1, 1987, the date of the first published laparoscopic cholecystectomy, through January 2023. 41 studies were included.RESULTS: Subtotal cholecystectomy's incidence oscillates between 4.00% and 9.38%. Strasberg et al., divided subtotal cholecystectomies in "fenestrating" and "reconstituting" types based on if the remaining portion of the gallbladder was left open or closed. Subtotal cholecystectomy can sometimes be a challenging procedure and is associated to a high rate of complications such as biliary fistula, retained gallstones, subhepatic or subphrenic collections, among others.CONSLUSION: Subtotal cholecystectomy is a safe alternative when facing difficult cholecystectomy in which the critical view of safety is not reached in order to avoid complications. A classification system should be implemented in surgical descriptions to compare the different surgical techniques employed. In order to avoid bile leakage and cholecystitis of the remnant gallbladder, the surgical technique must be performed skillfully. There is still a current lack of information on alternative techniques such as omental plugging or falciform patch in order to judge their utility. There needs to be further research on long-term complications such as malignancy of the remnant gallbladder.
AB - INTRODUCTION: Subtotal cholecystectomy is a type of surgical bail-out procedure indicated when facing difficult laparoscopic cholecystectomy due to not reaching the critical view of safety, inadequate identification of the anatomical structures involved and/or risk of injury.MATERIALS AND METHODS: A comprehensive search on PubMed were performed using the following Mesh terms: Subtotal cholecystectomy and Partial cholecystectomy. The PubMed databases were used to search for English-language reports related to Subtotal cholecystectomy between January 1, 1987, the date of the first published laparoscopic cholecystectomy, through January 2023. 41 studies were included.RESULTS: Subtotal cholecystectomy's incidence oscillates between 4.00% and 9.38%. Strasberg et al., divided subtotal cholecystectomies in "fenestrating" and "reconstituting" types based on if the remaining portion of the gallbladder was left open or closed. Subtotal cholecystectomy can sometimes be a challenging procedure and is associated to a high rate of complications such as biliary fistula, retained gallstones, subhepatic or subphrenic collections, among others.CONSLUSION: Subtotal cholecystectomy is a safe alternative when facing difficult cholecystectomy in which the critical view of safety is not reached in order to avoid complications. A classification system should be implemented in surgical descriptions to compare the different surgical techniques employed. In order to avoid bile leakage and cholecystitis of the remnant gallbladder, the surgical technique must be performed skillfully. There is still a current lack of information on alternative techniques such as omental plugging or falciform patch in order to judge their utility. There needs to be further research on long-term complications such as malignancy of the remnant gallbladder.
KW - bile duct injury
KW - critical view of safety
KW - difficult cholecystectomy
KW - laparoscopic cholecystectomy
KW - subtotal cholecystectomy
UR - http://www.scopus.com/inward/record.url?scp=85158165934&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/69984920-ee57-35cd-9549-4985bdfe051c/
U2 - 10.3389/fsurg.2023.1142579
DO - 10.3389/fsurg.2023.1142579
M3 - Artículo de revisión
C2 - 37151864
SN - 2296-875X
VL - 10
SP - 1142579
JO - Frontiers in Surgery
JF - Frontiers in Surgery
M1 - 1142579
ER -