Observational studySurgical endoscopy2025
Is subtotal cholecystectomy a safe strategy for difficult cases? Long-term outcomes in a high-volume center.
Observational study in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis 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
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Postoperative outcomes of reconstituting versus fenestrating subtotal cholecystectomy: a systematic review and meta-analysis of observational studies.BMC surgery · 2026Pooled it
- Reconstituting, Fenestrating, and Cholecystostomy-our approach and surgical technique for difficult gallbladders using three bailout procedures.Journal of visualized surgery · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSubtotal cholecystectomy (SC) is a bailout strategy for difficult gallbladders in which standard dissection may pose high risk of bile duct injury (BDI). However, concerns remain about postoperative complications.
methodsThis retrospective, observational study included 347 patients who underwent SC between February 2015 and September 2023 at a high-volume hepatobiliary center. A total of 7778 cholecystectomies were performed during the study period. SC was indicated intraoperatively based on severe inflammation or unclear anatomy of the hepatocystic triangle. The Pribram technique, defined by removal of the anterior wall, mucosal ablation, and preservation of the posterior wall, was used in 82.4% of cases. Intraoperative cholangiography was systematically performed. Outcomes included complications (Clavien-Dindo), bile leak, ERCP, reoperation, and follow-up.
resultsMedian operative time was 117 min (range 88-150), and median hospital stay was 2 days (range 1-4). Most procedures were completed laparoscopically (96.5%). The incidence of major complications (Clavien-Dindo ≥ III) was 3.4%, bile leak occurred in 1.4%, and no BDI or mortality were observed. Postoperative ERCP was required in 5.2%, and reoperation in 1.4% of cases. At a median follow-up of 23.2 months (range 11.4-37.6), no cases of stump lithiasis or cancer recurrence were recorded.
conclusionsSubtotal cholecystectomy, when combined with systematic intraoperative cholangiography, is a safe and effective strategy for managing difficult gallbladders. In our series, it was not associated with bile duct injury or mortality. These results suggest that even non-hepatobiliary surgeons can safely resolve complex cases by adopting subtotal techniques as a standardized 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.