ArticleSurgical endoscopy2021
Less is more in the difficult gallbladder: recent evolution of subtotal cholecystectomy in a single HPB unit.
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Postoperative outcomes of reconstituting versus fenestrating subtotal cholecystectomy: a systematic review and meta-analysis of observational studies.BMC surgery · 2026Pooled it
- Risk factors and outcomes of bailout procedures during laparoscopic cholecystectomy for acute cholecystitis: the BOLAC study.Surgical endoscopy · 2026Article
- Mucosal stripping cholecystectomy as a novel bailout procedure when subtotal cholecystectomy is not feasible: a case report.International journal of surgery case reports · 2026Article
- Adoption of robotic interval cholecystectomy: a retrospective comparison with the laparoscopic approach at a single center.Surgical endoscopy · 2026Article
- Robotic versus pure laparoscopic approach to subtotal fenestrating cholecystectomy: does the robot improve postoperative outcomes?Surgical endoscopy · 2026Article
- Utilization of the modified Kama scoring system for predicting bail-out cholecystectomy: a valuable tool in the era of rising laparoscopic surgery prevalence.Surgery today · 2024Article
- Beyond the Expected: Evaluating Preoperative Predictors of a Difficult Cholecystectomy Aboard the USNS Comfort.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Outcomes of laparoscopic subtotal cholecystectomy: a comparative analysis of fenestrating and reconstituting approaches in 170 cases.Surgical endoscopy · 2024Article
- Does the subtotal cholecystectomy rate for acute cholecystitis change with previous endoscopic retrograde cholangiopancreatography?Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2023Article
- Multiple logistic regression model to predict bile leak associated with subtotal cholecystectomy.Surgical endoscopy · 2023Article
- Subtotal cholecystectomy: is it a safe option for difficult gall bladders?Annals of the Royal College of Surgeons of England · 2023Article
- Review of the Literature on Partial Resections of the Gallbladder, 1898-2022: The Outline of the Conception of Subtotal Cholecystectomy and a Suggestion to Use the Terms 'Subtotal Open-Tract Cholecystectomy' and 'Subtotal Closed-Tract Cholecystectomy'.Journal of clinical medicine · 2023Review
- State of the art in subtotal cholecystectomy: An overview.Frontiers in surgery · 2023Review
- Robotic-assisted approach for complex cholecystectomies.Mini-invasive surgery · 2023Article
- Laparoscopic bailout surgery effective procedure for patients with difficult laparoscopic cholecystectomy.Updates in surgery · 2022Article
- Patient and surgeon factors contributing to bailout cholecystectomies: a single-institutional retrospective analysis.Surgical endoscopy · 2022Article
- Comparison of Fenestrating and Reconstituting Subtotal Cholecystectomy Techniques in Difficult Cholecystectomy.Cureus · 2022Article
- Open conversion in laparoscopic cholecystectomy and bile duct exploration: subspecialisation safely reduces the conversion rates.Surgical endoscopy · 2022Article
- WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections.World journal of emergency surgery : WJES · 2021Review
- Comparative Outcomes of Robotic Assisted Versus Laparoscopic Subtotal Cholecystectomy: A Retrospective Analysis of Surgical Efficacy and Postoperative Intervention.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
introductionSubtotal cholecystectomy (SC) is a technique to manage the difficult gallbladder and avoid hazardous dissection and biliary injury. Until recently it was used infrequently. However, because of reduced exposure to open total cholecystectomy in resident training, we recently adopted subtotal cholecystectomy as the bail-out procedure of choice for resident teaching. This study reports our experience and outcomes with subtotal cholecystectomy in the years immediately preceding adoption and since adoption.
methodsA retrospective analysis was conducted of patients undergoing SC from July 2010 to June 2019. Outcomes, including bile leak, reoperation and need for additional procedures, were analyzed. Complications were graded by the Modified Accordion Grading Scale (MAGS).
results1571 cholecystectomies were performed of which 71 were SC. Subtotal cholecystectomy patients had several indicators of difficulty including prior attempted cholecystectomy and previous cholecystostomy tube insertion. The most common indication for SC was marked inflammation in the hepatocystic triangle (51%). As our experience increased, fewer patients required open conversion to accomplish SC and SC was completed laparoscopically, usually subtotal fenestrating cholecystectomy (SFC). Most patients (85%) had a drain placed and 28% were discharged with a drain. The highest MAGS complication observed was grade 3 (11 patients, 15%). Six patients had a bile leak from the cystic duct resolved by ERCP. At mean follow-up of about 1 year no patient returned with recurrent symptoms.
conclusionsSubtotal fenestrating cholecystectomy is a useful technique to avoid biliary injury in the difficult gallbladder and can be performed with very satisfactory rates of bile fistula, ERCP, and reoperation.
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Registered trials
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