ReviewBMC surgery2025
The difficult laparoscopic cholecystectomy: a narrative review.
Review in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Artificial intelligence for predicting surgical difficulty in laparoscopic cholecystectomy: a systematic review and meta-analysis.Surgical endoscopy · 2026Pooled it
- Is robotic surgery ready for emergency cholecystectomy? A systematic review and meta-analysis of robotic versus laparoscopic approach in acute cholecystitis.Journal of robotic surgery · 2026Pooled it
- TempoSafe-CVS: A Temporal Multi-scale Deep Learning Framework for Automated Assessment of the Critical View of Safety in Laparoscopic Cholecystectomy.Journal of imaging informatics in medicine · 2026Article
- Cystic duct management in subtotal cholecystectomy: is closure necessary?Surgery today · 2026Article
- Learning where to look: scaling parkland grade prediction from surgical videos.International journal of computer assisted radiology and surgery · 2026Article
- Subtotal cholecystectomy as a bailout strategy in difficult cholecystectomy: Outcomes and patient selection criteria.Annals of hepato-biliary-pancreatic surgery · 2026Article
- Surgical Complications in Conventional and Laparoscopic Cholecystectomy in an Ecuadorian Reference Hospital.Cureus · 2026Article
- Article
- Navigating the Impossible Gallbladder: Bailout Strategies and Culture of Safety in Laparoscopic Cholecystectomy.Cureus · 2026Review
- Clinical characteristics and outcomes of patients undergoing laparoscopic cholecystectomy in a low-income country: Ethiopia.BMC surgery · 2026Article
- Effect of perioperative intervention based on the theory of planned behavior on preventing deep vein thrombosis after laparoscopic cholecystectomy: a retrospective study.Frontiers in surgery · 2026Article
- Prevalence of gallstone disease in India: insights from a community-based cross-sectional study.BMJ public health · 2026Article
- Application of three-step laparoscopic cholecystectomy combined with indocyanine green fluorescence imaging in acute difficult cholecystitis.Frontiers in medicine · 2026Article
- Laparoscopic cholecystectomy for double gallbladder malformation with cystic duct variation: a case report.Frontiers in surgery · 2026Article
- Redefining precision in biliary surgery: a paradigm shift from operative mastery to prognostic-driven strategy.Frontiers in surgery · 2026Article
- Surgical outcomes of indocyanine green fluorescent cholangiography in emergency laparoscopic cholecystectomy performed by junior surgeons for acute cholecystitis.Frontiers in surgery · 2026Article
- Factors influencing the difficulty of laparoscopic cholecystectomy: A review.Bioinformation · 2026Article
- Association of indocyanine green fluorescence navigation with extrahepatic biliary anatomy identification and operative efficiency in laparoscopic cholecystectomy: a retrospective cohort study.Frontiers in medicine · 2026Article
- Robotic-assisted cholecystectomy with DEXTERSurgical endoscopy · 2025Article
- Anatomical Trickery in Acute Cholecystitis: Very Low Cystic Duct Insertion Near the Ampulla of Vater.Cureus · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background/purposeLaparoscopic cholecystectomy is one of the most commonly performed general surgical procedures. Difficult laparoscopic cholecystectomy is associated with increased operative time, hospital stay, complication rates, open conversion, treatment costs, and mortality. This study aimed to provide a comprehensive literature review on difficult laparoscopic cholecystectomy.
methodsA literature search was conducted for articles published in English up to June 2024 using common databases including PubMed/MIDLINE, Web of Science, Google Scholar, and ScienceDirect. Keywords included "safe laparoscopic cholecystectomy", "difficult laparoscopic cholecystectomy", "acute cholecystitis", "prevention of bile duct injuries", "intraoperative cholangiography," "bailout procedure," and "subtotal cholecystectomy". Only clinical trials, systematic reviews/meta-analyses, and review articles were included. Studies involving children, robotic cholecystectomy, single incision laparoscopic cholecystectomy, open cholecystectomy, and cholecystectomy for indications other than gallstone disease were excluded. RESULTS/DISCUSSION: Emergency laparoscopic cholecystectomy for acute cholecystitis is ideally performed within 72 h of symptom onset, with a maximum window of 7-10 days. Intraoperative cholangiography can help clarify unclear biliary anatomy and detect bile duct injuries. In the "impossible gallbladder", laparoscopic cholecystostomy or gallbladder aspiration may be considered. When dissection of Calot's triangle is deemed hazardous or impossible, the fundus-first approach allows for completion of the procedure with either total cholecystectomy or subtotal cholecystectomy. Subtotal cholecystectomy is effective in preventing bile duct injuries, can be performed laparoscopically, and is currently the best available bailout approach for difficult laparoscopic cholecystectomy.
conclusionDifficult laparoscopic cholecystectomy is a common clinical scenario that requires a judicious approach by experienced surgeons in appropriate settings. When difficult laparoscopic cholecystectomy is encountered, various bailout strategies are available. Currently, subtotal cholecystectomy is likely the most effective bailout approach.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.