Butt F, Butt A F, Butt I I.
Subtotal Laparoscopic Cholecystectomy: Our Experience Of 32 Patients.
Biomedica Jan ;33(1):25-8.

Background and Objective: Laparoscopic Cholecystectomy (LC) is a commonly performed procedure for cholelithiasis. However, in cases with difficult surgical anatomy, instead of converting it to open procedure, an option is to go for subtotal laparoscopic cholecystectomy (SLC), which is a safe alternative with minimal morbidities. The objective of this study was to determine the post-operative course and outcome of patients undergoing SLC at our setup. Methods: This retrospective descriptive case series was conducted at Medicare International Hospital Gill Road Gujranwala and Allama Iqbal memorial Trust Hospital Gujranwala. All the patients who had been operated for SLC in the hospital over the period of last 5 years, from January, 2012 to December, 2016, were included in the study. All details of these patients were reviewed. During this period, a total of 746 patients underwent LC. From all these 746 LC, 36 were SLC. All the data were entered on a predesigned proforma. All data were analyzed by SPSS version 20. Results: A total of 746 LC’s were performed in this duration. SLC was performed in 36 patients. The frequency of SLC was found as 4.8%. Among these 36 patients, 4 patients had carcinoma of GB, so they were excluded and data was calculated for 32 patients. The mean age of patients was found to be 47.78 ± 8.96 years. Among these 32 patients, 25 patients (78.1%) were females. The mean length of preoperative hospital stay was 1.40 ± 0.55 days. The mean operative time was found as 73.15 ± 1.99 minutes. Post-operative drain was placed in all of these patients and mean post-operative drain time was found as 1.90 ± 0.96 days. Regarding complications, 2 patients had minor biliary leak, one patient had intra-abdominal abscess formation and one patient had bleeding in drain in post-operative period. The most common reason for SLC was difficult anatomy, followed by sever adhesions, acute cholecystitis and sessile GB. Conclusion: We conclude that SLC is a safe procedure with minimal morbidity and complication rate. So it may be opted as an alternative to conversion to open procedure safely, but after ruling out malignancy of GB. We also recommend SLC in those patients needing shorter anesthesia, weighing the side effects of longer anesthesia and doing SLC.

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