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Cirujano general
versão impressa ISSN 1405-0099
Resumo
HERNANDEZ CENTENO, José Raúl et al. Subtotal cholecystectomy as a management option for difficult cholecystectomy. Cir. gen [online]. 2021, vol.43, n.2, pp.79-85. Epub 05-Dez-2022. ISSN 1405-0099. https://doi.org/10.35366/106718.
Objective:
To describe the risks associated with subtotal cholecystectomy in patients with difficult cholecystectomy.
Material and methods:
A two-year review of the database of the Hospital General León was performed within the period January 2013-December 2015. This is a retrospective study with reconstructed cohort analyzes that determine the risks associated with the intervention.
Results:
Reporting 18 patients operated on for subtotal cholecystectomy due to difficult cholecystectomy. In 18 patients included in the study, the associated morbidity of 44.4% (33.4% bile leak, 5.5% surgical site infection and 5.5% residual choledocholithiasis) was found. The most frequent postoperative complication is bile leakage, 83.3% resolved non-operatively and 16.7% required ERCP with a sphincterotomy for its resolution. No associated mortality or bile duct injuries were found in this cohort.
Conclusion:
Subtotal cholecystectomy is a safe, feasible and reproducible procedure as a management option for difficult cholecystectomy and that maintains the incidence of bile duct injury on neutral margins.
Palavras-chave : Laparoscopic cholecystectomy; difficult cholecystectomy; fenestrated subtotal cholecystectomy; reconstituted subtotal cholecystectomy; bile leak.