CLINICAL OUTCOME OF LAPAROSCOPIC SUBTOTAL CHOLECYSTECTOMY IN THE TREATMENT OF COMPLICATED CHOLECYSTITIS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 21
Abstract
Laparoscopic cholecystectomy has replaced open cholecystectomy as the surgical procedure of choice for symptomatic gallstones. The presence of risk factors such as difficult Calot’s triangle, various liver pathologies like hard fibrotic liver tissue as seen in chronic cholecystitis, severe adhesions between the liver and gallbladder wall, oedematous tissue in severe acute cholecystitis and neovascularity as in cirrhotic liver make the dissection very difficult and dangerous. The present study was conducted to evaluate the role and outcome of laparoscopic subtotal cholecystectomy in the treatment of complicated cholecystitis. MATERIALS AND METHODS This was a descriptive study conducted on all patients who underwent laparoscopic subtotal cholecystectomy at Dayanand Medical College, Ludhiana from 1st January 2014 to 30th June 2017. Details of the patients were retrieved and analysed for demographic data, history and clinical findings, investigations, operative findings, length of hospital stay, complications and outcome. RESULTS The total number of laparoscopic cholecytectomies done during the total duration of the study was 1,926. The overall incidence of laparoscopic subtotal cholecystectomy in our study was 1.1%. CONCLUSION Laparoscopic subtotal cholecystectomy may be a safe alternative to open subtotal cholecystectomy in patients with various forms of complicated cholecystitis. If difficulty is encountered when dissecting the neck and Calot’s triangle, isolating the cystic duct is unnecessary and the conversion rate decreases by devising alternate methods for handling hostile Calot’s triangle as described in this study. This study demonstrates that laparoscopic subtotal cholecystectomy is associated with a reduced risk of severe complications in the patients with complicated cholecystitis.
Authors and Affiliations
Varun Gupta, Vinay Karwal, Sanjeev Kumar Singla, Manvi Gupta
Keywords
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- EP ID EP431603
- DOI 10.14260/jemds/2018/570
- Views 103
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