Application of laparoscopic subtotal cholecystectomy for complicated laparoscopic cholecystectomy

Abstract

Objective To evaluate the application of laparoscopic subtotal cholecystectomy (LSC) for complicated laparoscopic cholecystectomy(LC).Methods From June,2006 to February,2009,40 patients with complicated cholecystitis underwent LSC in our hospital were admitted.9 were operated by leaving the posterior wall intact with the liver (LSC Ⅰ),18 were operated by leaving the cystic duct(LSC Ⅱ),13 with a combination of LSC Ⅰ and LSC Ⅲ(LSC Ⅲ).According to rules of same sex.similar inflammation and complicated degree,40 cases were selaparoscopy successfully,none was converted to laparotomy and damaged the bile duct.Intraoperative bleeding in LSC group(73±26)ml increased significantly than those in LC group(41±12)ml(t=4.183,P 0.05).In LSC group,operators were mostly the laparoscopie surgeon with five to ten years experience(32/8),whereas in LC group,mostly were with above ten years experience(7/33)(χ~2=34.690,P 0.05).All patients were cured,and no complications occurred.Conclusions LSC is a safe and effective procedure in LC with complicated cholecystitis,without incurring of laparotomy. Key words: Cholecystolithiasis; Laparoscopic subtotal cholecystectomy; Laparoscopic cholecystectomy