ArticleScientific reports2019
Fundus first as the standard technique for laparoscopic cholecystectomy.
Article in Scientific reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 27 citations in OpenAlex.
- Ultrasonic dissection versus electrocautery dissection in laparoscopic cholecystectomy for acute cholecystitis: a randomized controlled trial (SONOCHOL-trial).World journal of emergency surgery : WJES · 2024Trial
- Fundus-first dissection: a salvage technique for the difficult laparoscopic cholecystectomy.Surgical endoscopy · 2026Article
- Optimizing robotic cholecystectomy: improving cost-effectiveness with non-inferior safety and efficacy.Journal of robotic surgery · 2026Article
- Navigating the Impossible Gallbladder: Bailout Strategies and Culture of Safety in Laparoscopic Cholecystectomy.Cureus · 2026Review
- Efficacy of laparoscopic bailout surgery for moderate and severe acute cholecystitis.Scientific reports · 2025Article
- Indocyanine green fluorescence improves safety in laparoscopic cholecystectomy using the Fundus First technique: a retrospective study.Frontiers in surgery · 2025Article
- Article
- Safety of cholecystectomy performed by surgeons who prefer fundus first versus surgeons who prefer a standard laparoscopic approach.Surgery open science · 2024Article
- Article
- Subtotal cholecystectomy: is it a safe option for difficult gall bladders?Annals of the Royal College of Surgeons of England · 2023Article
- Efficacy of bailout surgery for preventing intraoperative biliary injury in acute cholecystitis.Surgical endoscopy · 2023Article
- Comparative evaluation of three laparoscopic cholecystectomy techniques in rabbit's model.Acta cirurgica brasileira · 2023Article
- Subtotal Cholecystectomy Results in High Peri-operative Morbidity and Its Risk-Profile Should be Emphasised During Consent.World journal of surgery · 2022Article
- Achieving the critical view of safety in the difficult laparoscopic cholecystectomy: a prospective study of predictors of failure.Surgical endoscopy · 2021Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In previous studies the fundus first technique (FF) has been a cost-effective way to simplify the laparoscopic cholecystectomy (LC) and facilitate patient rehabilitation. The feasibility and safety profile when introducing FF as the standard technique were aimed in this study. Between 2004-2014, 29 surgeons performed 1425 LC with FF and 320 with a conventional technique. During the first year 56% were with FF and 98% during the last four years. More females, ultrasonic shears, urgent operations, daycare operations and a shorter operation time were found with FF. 63 (3.6%) complications occurred: 10 (0.6%) bleedings, 33 (1.9%) infections and 12 (0.7%) bile leakages. Leakage from cystic duct occurred in 4/112 (3.6%) when closed with ultrasonic shears and in 4/1633 (0.2%) with clips (p 0.008). A common bile duct lesion occurred in 1/1425 (0.07%) with FF and in 3/320 (0.9%) with the conventional approach (p 0.003). In a multivariate regression model, the conventional technique was a risk factor for bile duct injury with an odds ratio of 20.8 (95% CI 1.6-259.2). In conclusion FF was effectively established as the standard procedure and associated with lower rates of bile duct injuries. Clipless closure of the cystic duct increased the rate of leakage.
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