Safety analysis of laparoscopic gallbladder disabled technique for atrophic cholecystitis

Abstract

Objective To summarize key skills and to explore safety of laparoscopic gallbladder disabled technique for atrophic cholecystitis. Methods From March 2007 to February 2018, 313 patients with atrophic cholecystitis received damage control surgery, including laparoscopic subtotal cholecystectomy, partial cholecystectomy and splitting approach. For the large volume atrophic cholecystitis, anatomy of gallbladder and extrahepatic bile duct were confirmed using imaginary clock localization method. For small volume atrophic cholecystitis, Bail-out procedures such as subtotal fenestrating cholecystectomy or subtotal reconstituting cholecystectomy were generally performed. Laparoscopic homochronous operation was performed to treat the complicated choledocholithiasis. Results All of patients including 129 cases with large volume atrophic cholecystitis and 184 cases with small volume atrophic cholecystitis, underwent successful laparoscopic operation without conversion to laparotomy. Forty-seven cases with comlicated choledocholithiasis underwent laparoscopic common bile duct exploration, There were 142 cases of three-ports, 169 cases of four-ports and 2 cases of five-ports methods, without bile duct injury. Conclusion A safe laparoscopic treatment for atrophic cholecystitis includes removal of stone, disable gallbladder, proper surgical treatment of the cystic duct and gallbladder. Key words: Cholecystitis; Cholecystolithiasis; Cholecystectomy, laparoscopic