P-BN54 The outcomes after a Laparoscopic subtotal cholecystectomy

Abstract

Abstract Background Laparoscopic subtotal cholecystectomy (LSC) is a recognised option when the “critical view” cannot be safely delineated. It carries a high morbidity rate as there are increased frequencies of a bile leak occurring however reducing the risk of bile duct injury. LSC can be further divided into fenestrating or reconstituting cholecystectomy, the later entails closing the remnant. The literature state reconstituting cholecystectomy reduced rate of bile leak. We reviewed our cases to analyse the complication rates of LSC and there outcomes. Methods A retrospective review of patients who underwent a laparoscopic subtotal cholecystectomy (LSC) using electronic records between January 2015 to March 2021. A total of 160 patients, with a mean age of 65, 51% male and 49% female. Results 76% of LSC were performed as an emergency. Mean operation length was 96min and the mean blood loss 92ml. Complications occurred in 50% of patients. Post operatively 22% underwent an ERCP and the re-operation rate was 9%. The mean length of stay was 8 days. Conclusions Based on our results LSC carry a high rate of bile leak with the majority requiring intervention in the form of ERCP or laparoscopy and wash out. A reconstituting cholecystectomy, closing with an endoloop of suture seems to slightly reduce the rate of bile leak. LSC are only performed when managing a difficult gallbladder with a dense/ inflamed Calot's triangle. There were no mortalities associated with a LSC.