Subtotal cholecystectomy for difficult acute cholecystitis: how to finalize safely by laparoscopy—a systematic review
| العنوان: | Subtotal cholecystectomy for difficult acute cholecystitis: how to finalize safely by laparoscopy—a systematic review |
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| المؤلفون: | Fausto Catena, Elena Schembari, Isidoro Di Carlo, Michele Teodoro, Mansoor Khan, Adriana Toro, Salomone Di Saverio |
| المصدر: | World Journal of Emergency Surgery, Vol 16, Iss 1, Pp 1-10 (2021) World Journal of Emergency Surgery : WJES |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Complications, RD1-811, Laparoscopic subtotal cholecystectomy, medicine.medical_treatment, Cholecystitis, Acute, Review, Abdominal cavity, Difficulty cholecystectomy, medicine, Acute cholecystitis, Humans, Cholecystectomy, Laparoscopy, Clavien–Dindo classification, Grade IIIa, medicine.diagnostic_test, RC86-88.9, business.industry, Gallbladder, Medical emergencies. Critical care. Intensive care. First aid, Subtotal cholecystectomy, Surgery, medicine.anatomical_structure, Cholecystectomy, Laparoscopic, Emergency Medicine, business |
| الوصف: | Background Aim of this study was to clarify the best laparoscopic subtotal cholecystectomy (LSTC) technique for finalizing a difficult cholecystectomy. Patients and methods A review was performed (1987–2021) searching "difficulty cholecystectomy" AND/OR "subtotal cholecystectomy". The LSTC techniques considered were as follows: type A, leaving posterior wall attached to the liver and the remainder of the gallbladder stump open; type B, like type A but with the stump closed; type C, resection of both the anterior and posterior gallbladder walls and the stump closed; type D, like type C but with the stump open. Morbidity (including mortality) was analysed with Dindo–Clavien classification. Results Nineteen articles were included. Of the 13,340 patients screened, 678 (8.2%) had cholecystectomy finalized by LSTC: 346 patients (51.0%) had type A LSTC, 134 patients (19.8%) had type B LSTC, 198 patients (29.2%) had type C LSTC, and 198 patients (0%) had type D LSTC. Bile leakage was found in 83 patients (12.2%), and recorded in 58 patients (69.9%) treated by type A. Twenty-three patients (3.4%) developed a subhepatic collection, 19 of whom (82.6%) were treated by type A. Other complications were reported in 72 patients (10.6%). The Dindo–Clavien classification was four for grade I, 27 for grade II, 126 for grade IIIa, 18 for grade IIIb, zero for grade IV and three for grade V. Conclusion In the case of LSTC, closure of the gallbladder stump represents the best method to avoid complications. Careful exploration of the gallbladder stump is mandatory, washing the abdominal cavity and leaving drainage. |
| تدمد: | 1749-7922 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b81c11754eba08f31c6fe5480a4bb7fbTest https://doi.org/10.1186/s13017-021-00392-xTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b81c11754eba08f31c6fe5480a4bb7fb |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17497922 |
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