Detailed Abstract
[E-poster - Biliary & Pancreas (Biliary Disease/Surgery)]
[EP 148] Laparoscopic Subtotal Cholecystectomy Is an Alternative Treatment Option to Protect Common Bile Duct on Severe Inflammatory Gall Bladder; Multicenter Retrospective Cohort Study.
Sung Eun PARK 1, Kwang Yeol PAIK 2
1 Hepato-biliary And Pancreas Surgery, The Catholic University of Korea Seoul St. Mary's Hospital, REPUBLIC OF KOREA, 2 Hepato-biliary And Pancreas Surgery, The Catholic University of Korea Yeouido St. Mary's Hospital, REPUBLIC OF KOREA
Background : Subtotal cholecystectomy (STC) is described as an alternative for severe inflammation, but comparisons to laparoscopic total cholecystectomy (LTC) are lacking. We compared outcomes after laparoscopic STC (LSTC) versus LTC.
Methods : A retrospective matched cohort study compared LTC (n=268) to LSTC (n=51) from 2014-2022 across two centers. Patients had acute cholecystitis meeting Tokyo Guidelines criteria with inability to obtain a critical view of safety intraoperatively. Outcomes included operative duration, bile duct injuries, bile leaks, surgical site infections, length of stay, and reoperations.
Results : A total of 268 patients who underwent laparoscopic cholecystectomy and 51 who underwent LSTC were included in the study. There were no differences in baseline characteristics between the two groups, except the LSTC group had more undergone preoperative percutaneous transhepatic gallbladder drainage (PTGBD) than the LTC group (45.1 % vs. 25.8 %, p = 0.007). There were no significant differences in the morbidity rate (p = 0.456), incidence of intraoperative bile duct injury (0% vs. 5.5%, p = 0.086), postoperative bile leakage (5.9% vs. 6.9%, p = 0.791), and surgical site infection (0% vs. 3.2%, p = 0.194) between the two groups. Additionally, there were no differences in readmission (p = 0.327), reoperation rate (p = 1.000), or the length of hospital stay (p = 0.685).
Conclusions : For severe gallbladder inflammation, LSTC demonstrates comparable safety to LTC, without increased bile duct injuries or leaks, supporting LSTC as an alternative when the critical view cannot be obtained.
Methods : A retrospective matched cohort study compared LTC (n=268) to LSTC (n=51) from 2014-2022 across two centers. Patients had acute cholecystitis meeting Tokyo Guidelines criteria with inability to obtain a critical view of safety intraoperatively. Outcomes included operative duration, bile duct injuries, bile leaks, surgical site infections, length of stay, and reoperations.
Results : A total of 268 patients who underwent laparoscopic cholecystectomy and 51 who underwent LSTC were included in the study. There were no differences in baseline characteristics between the two groups, except the LSTC group had more undergone preoperative percutaneous transhepatic gallbladder drainage (PTGBD) than the LTC group (45.1 % vs. 25.8 %, p = 0.007). There were no significant differences in the morbidity rate (p = 0.456), incidence of intraoperative bile duct injury (0% vs. 5.5%, p = 0.086), postoperative bile leakage (5.9% vs. 6.9%, p = 0.791), and surgical site infection (0% vs. 3.2%, p = 0.194) between the two groups. Additionally, there were no differences in readmission (p = 0.327), reoperation rate (p = 1.000), or the length of hospital stay (p = 0.685).
Conclusions : For severe gallbladder inflammation, LSTC demonstrates comparable safety to LTC, without increased bile duct injuries or leaks, supporting LSTC as an alternative when the critical view cannot be obtained.
SESSION
E-poster
E-Session 03/21 ALL DAY