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Etherington MS, Handzel R, Ongchin M, Choudry MH, Tohme ST, Paniccia A, Lee KK, Zureikat A, Geller DA. Remnant completion cholecystectomy is on the rise: Don't three-putt it. HPB (Oxford) 2024; 26:1072-1074. [PMID: 38735816 DOI: 10.1016/j.hpb.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 04/19/2024] [Indexed: 05/14/2024]
Affiliation(s)
- Mark S Etherington
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Robert Handzel
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Melanie Ongchin
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - M Haroon Choudry
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Samer T Tohme
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Alessandro Paniccia
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Kenneth K Lee
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Amer Zureikat
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - David A Geller
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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2
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Nordness MF, Smith MC, Fogel J, Guillamondegui OD, Dennis BM, Gunter OL. Incidence of Endoscopic Retrograde Cholangiography after Subtotal Fenestrating and Reconstituting Cholecystectomy. J Am Coll Surg 2024; 239:145-149. [PMID: 38477475 PMCID: PMC11254557 DOI: 10.1097/xcs.0000000000001072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
BACKGROUND Laparoscopic subtotal cholecystectomy (SC) is used for the difficult cholecystectomy, but published experience with resource use for SC is limited. We hypothesized that the need for advanced resources are common after SC. STUDY DESIGN This was a retrospective review of laparoscopic cholecystectomies between 2017 and 2021 at a large center. SC cases were identified using a medical record tool. Baseline characteristics were assessed with Student's t -test and chi-square test. Primary outcome was endoscopic retrograde cholangiography (ERC) within 60 days. Secondary outcomes were reconstituted SC on postoperative ERC and length of stay (LOS). Uni- and multivariable logistic regression were used for binary outcomes. Multiple linear regression was used for LOS. Covariates included were age, sex, BMI, and American Society of Anesthesiology class. RESULTS A total of 1,222 laparoscopic cholecystectomies were performed between 2017 and 2021. Of these, 87 (7%) were SC. Male (p < 0.001) and older (p < 0.001) patients were more likely to undergo SC. Odds of postoperative ERC were higher in the SC group (odds ratio 9.79, 95% CI 5.90 to16.23, p < 0.001). There was no difference in preoperative ERC (17% vs 21%, p = 0.38). Reconstituting SC had lower odds of postoperative ERC (odds ratio 0.12, 95% CI 0.023 to 0.58, p = 0.009). LOS was 1.81 times higher in the SC group (p ≤ 0.001). Postoperative ERC was not associated with LOS (p = 0.24). CONCLUSIONS We present one of the largest single-center series of SC. Patients who underwent SC are more likely to be male, older, have higher American Society of Anesthesiology class, and have increased LOS. SC should be performed when access to ERC and interventional radiology is available. In the absence of these adjuncts, reconstituting SC decreases the need for early ERC, but long-term outcomes are unknown.
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Affiliation(s)
- Mina F. Nordness
- Division of Acute Care Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Michael C. Smith
- Division of Acute Care Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Jessa Fogel
- Vanderbilt University Medical School, Nashville, TN
- Department of Orthopedic Surgery, University of Maryland, Baltimore, MD
| | - Oscar D. Guillamondegui
- Division of Acute Care Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Bradley M. Dennis
- Division of Acute Care Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Oliver L. Gunter
- Division of Acute Care Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN
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Miri A, Abdessalam S, Powers AM, Quiros‐Tejeira RE, Dike CR. Gallbladder remnant: A potential source for biliary stones postcholecystectomy; a case report in a child with sickle cell disease. JPGN REPORTS 2024; 5:162-165. [PMID: 38756117 PMCID: PMC11093913 DOI: 10.1002/jpr3.12039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/28/2023] [Accepted: 12/24/2023] [Indexed: 05/18/2024]
Abstract
Stone formation in a gallbladder remnant is a rare postcholecystectomy complication. This report describes the case of gallstones in a gallbladder remnant of an adolescent with sickle cell disease (SCD) years after laparoscopic cholecystectomy. A 15-year-old female with SCD presented to our gastroenterology clinic with concerns of recurrent choledocholithiasis despite cholecystectomy 2 years before presentation. About 4 months before presentation to our clinic, she was evaluated at the referring physician's emergency department for recurrent severe abdominal pain of 1 month duration. After admission to the hospital, common bile duct stones were seen on magnetic resonance cholangiopancreatography (MCRP) imaging and subsequently removed via endoscopic retrograde cholangiopancreatography (ERCP). On review of her MRCP and ERCP at our hospital, a remnant of gallbladder containing multiple stones was identified. She subsequently underwent a laparoscopic resection of the gallbladder remnant. Clinicians should consider biliary duct imaging in children with biliary colic following cholecystectomy, especially those with history of chronic hemolysis.
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Affiliation(s)
- Ahmad Miri
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and NutritionUniversity of Nebraska Medical CenterOmahaNebraskaUSA
| | | | - Andria M. Powers
- Department of Pediatrics, Division of Pediatric RadiologyUniversity of Nebraska Medical CenterOmahaNebraskaUSA
| | - Ruben E. Quiros‐Tejeira
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and NutritionUniversity of Nebraska Medical CenterOmahaNebraskaUSA
| | - Chinenye R. Dike
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and NutritionUniversity of Nebraska Medical CenterOmahaNebraskaUSA
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and NutritionUniversity of Alabama at BirminghamBirminghamAlabamaUSA
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4
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Ibrahim R, Abdalkoddus M, Mownah OA, Chanthu A, Yao L, Aroori S. Safety profile and outcomes of intraoperative ultrasound-guided remnant cholecystectomy. Ann R Coll Surg Engl 2023; 105:528-531. [PMID: 36748801 PMCID: PMC10313443 DOI: 10.1308/rcsann.2022.0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2022] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Subtotal cholecystectomy (STC) is a safe approach in difficult cholecystectomies to prevent bile duct and vascular injury. However, the gallbladder remnant can become symptomatic, necessitating further surgical intervention. This study evaluates the safety profile and perioperative outcomes of remnant cholecystectomy (RC) performed under intraoperative ultrasound guidance. METHODS We retrospectively reviewed the records of all patients that underwent RC under intraoperative ultrasound guidance in 2009 and 2019. Pre-, intra- and postoperative details of patients who underwent RC were obtained from patients' electronic and paper copy records. RESULTS Ninety-seven patients underwent STC during the study period. Of this cohort, 16 patients (16.5%) presented with symptomatic gallbladder remnant over a median follow-up period of 14 months (interquartile range [IQR] 2-26). The median age was 64 years (IQR 54-69) with an equal male-to-female distribution. The median body mass index was 31kg/m2 (IQR 28-33). Twelve of 16 patients (75%) then proceeded to elective RC. Intraoperative ultrasound was used in all cases to identify the location of the remnant gallbladder and biliary anatomy. The median operative time was 88min (IQR 80-96), with 67% completed laparoscopically. No patients suffered bile duct injury. The median hospital stay was 3 days (IQR 1-5). During the follow-up period, eight patients (67%) reported symptom resolution. CONCLUSIONS RC is a safe operation that can be performed laparoscopically even after previous open subtotal cholecystectomy. We recommend the routine use of intraoperative ultrasound as an adjunct for identifying remnant gallbladder and biliary anatomy in all patients.
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Affiliation(s)
| | | | - OA Mownah
- University Hospitals Plymouth NHS Trust, UK
| | - A Chanthu
- University Hospitals Plymouth NHS Trust, UK
| | - L Yao
- University Hospitals Plymouth NHS Trust, UK
| | - S Aroori
- University Hospitals Plymouth NHS Trust, UK
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Ng ZQ, Brett O, Delriviere L. Necrotising fasciitis of abdominal wall following rupture of reconstituted remnant gallbladder. BMJ Case Rep 2023; 16:e254312. [PMID: 36599489 PMCID: PMC9815038 DOI: 10.1136/bcr-2022-254312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Zi Qin Ng
- Department of General Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Oscar Brett
- Department of General Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Luc Delriviere
- Department of General Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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Ramírez-Giraldo C, Torres-Cuellar A, Van-Londoño I. State of the art in subtotal cholecystectomy: An overview. Front Surg 2023; 10:1142579. [PMID: 37151864 PMCID: PMC10162495 DOI: 10.3389/fsurg.2023.1142579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/31/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction Subtotal cholecystectomy is a type of surgical bail-out procedure indicated when facing difficult laparoscopic cholecystectomy due to not reaching the critical view of safety, inadequate identification of the anatomical structures involved and/or risk of injury. Materials and methods A comprehensive search on PubMed were performed using the following Mesh terms: Subtotal cholecystectomy and Partial cholecystectomy. The PubMed databases were used to search for English-language reports related to Subtotal cholecystectomy between January 1, 1987, the date of the first published laparoscopic cholecystectomy, through January 2023. 41 studies were included. Results Subtotal cholecystectomy's incidence oscillates between 4.00% and 9.38%. Strasberg et al., divided subtotal cholecystectomies in "fenestrating" and "reconstituting" types based on if the remaining portion of the gallbladder was left open or closed. Subtotal cholecystectomy can sometimes be a challenging procedure and is associated to a high rate of complications such as biliary fistula, retained gallstones, subhepatic or subphrenic collections, among others. Conslusion Subtotal cholecystectomy is a safe alternative when facing difficult cholecystectomy in which the critical view of safety is not reached in order to avoid complications. A classification system should be implemented in surgical descriptions to compare the different surgical techniques employed. In order to avoid bile leakage and cholecystitis of the remnant gallbladder, the surgical technique must be performed skillfully. There is still a current lack of information on alternative techniques such as omental plugging or falciform patch in order to judge their utility. There needs to be further research on long-term complications such as malignancy of the remnant gallbladder.
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Affiliation(s)
- Camilo Ramírez-Giraldo
- General Surgery Department, Hospital Universitario Mayor – Méderi, Bogotá, Colombia
- Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Correspondence: Camilo Ramírez-Giraldo
| | - Andrés Torres-Cuellar
- Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Isabella Van-Londoño
- Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
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Huang H, Du D, Wang Z, Xie Y, Ni Z, Li X, Jin H. Application of Intraoperative Fluorescence Imaging with Indocyanine Green in the Difficult Gallbladder: A Comparative Study between Indocyanine Green-Guided Fluorescence Cholangiography and Conventional Surgery. J Laparoendosc Adv Surg Tech A 2022; 33:404-410. [PMID: 36577039 DOI: 10.1089/lap.2022.0467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background: In the difficult gallbladder, the rate of bile duct injury (BDI) remains high. To lessen iatrogenic biliary injury, we attempted to utilize indocyanine green (ICG)-guided fluorescence cholangiography during surgery to illuminate the extrahepatic biliary tract. Materials and Methods: According to admission criteria, 38 patients were diagnosed with difficult gallbladder and underwent percutaneous transhepatic gallbladder drainage (PTGBD). Consecutive patients who underwent ICG-assisted laparoscopic biliary surgery (n = 18, ICG group) or conventional laparoscopic biliary surgery (n = 20, white light [WL group) were enrolled in this study. ICG group received ICG fluorescent cholangiography via PTGBD tube during operation; 16 cases of laparoscopic cholecystectomy (LC) and 2 cases of LC plus laparoscopic common bile duct exploration (LC+LCBDE) were performed by fluorescent laparoscopy. In the WL group, 16 cases of LC, 1 case of laparoscopic subtotal cholecystectomy (LSC), and 3 cases of LC+LCBDE were performed under white light without ICG. Result: The biliary system was successfully established in the ICG group. Compared with the WL group, the anatomy of the Calot's triangle with severe abdominal adhesion or local inflammatory edema was more clearly displayed by fluorescence. Laparoscopic surgery was completed in both groups without conversion to laparotomy. There were no significant differences in surgery-related complications (P = .232) and postoperative hospital stay (P = .074) between the two groups. However, compared with the WL group, the ICG group had less intraoperative blood loss (P = .002) and shorter operation duration (P = .006). Conclusion: ICG fluorescence cholangiography has good clinical application value in the difficult gallbladder, which can avoid iatrogenic BDI, reduce surgery-related complications and intraoperative blood loss, and shorten the duration of surgery.
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Affiliation(s)
- Hai Huang
- Department of General Surgery, Hangzhou Hospital of Traditional Chinese Medicine, affiliated to Zhejiang Chinese Medicine University, Hangzhou, China
| | - Danwei Du
- Department of General Surgery, Hangzhou Hospital of Traditional Chinese Medicine, affiliated to Zhejiang Chinese Medicine University, Hangzhou, China
| | - Ziqiang Wang
- Department of Breast Armor Surgery, the First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Yangyang Xie
- Department of General Surgery, Hangzhou Hospital of Traditional Chinese Medicine, affiliated to Zhejiang Chinese Medicine University, Hangzhou, China
| | - Zhongkai Ni
- Department of General Surgery, Hangzhou Hospital of Traditional Chinese Medicine, affiliated to Zhejiang Chinese Medicine University, Hangzhou, China
| | - Xiaowen Li
- Department of General Surgery, Hangzhou Hospital of Traditional Chinese Medicine, affiliated to Zhejiang Chinese Medicine University, Hangzhou, China
| | - Haimin Jin
- Department of General Surgery, Hangzhou Hospital of Traditional Chinese Medicine, affiliated to Zhejiang Chinese Medicine University, Hangzhou, China
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8
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Xu X, Shi Z, Zhang H, Sun W, Zhao M, Peng X. Value of Auricular Point Pressing in Postoperative Pain Nursing Care of Laparoscopic Cholecystectomy Under the Guidance of Nano-Probe. J Biomed Nanotechnol 2022. [DOI: 10.1166/jbn.2022.3391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This work aimed to investigate and analyse the application value of auricular point pressing (APP) in pain nursing care after laparoscopic cholecystectomy guided by nano-probe. In this study, 100 patients who underwent laparoscopic cholecystectomy guided by nanoprobes were selected.
According to the difference in admission time and intervention measures, 100 patients meeting the inclusion criteria were enrolled into an observation group (n = 50) and a control group (n = 50). Then, patients as controls after surgery were treated with routine preventive nursing
intervention measures, and patients for observation received APP on the basis of routine nursing. Anal exhaust time (AET), bowel sound recovery time (BSRT), incidence of abdominal distension, and clinical efficacy were compared. In addition, the degree of abdominal pain was evaluated at the
24th hour, 48th hour, and 72nd hour after surgery, as well as the degree of gastrointestinal reaction. There was no marked difference in the general data of patients from the two groups. The time of first exhaust defecation in the observation group was shorter (P <0.05), indicating
that the exhaust effect was better. The differences in degree of abdominal pain in patients were statistically marked between the 24th and 48th hours and the 48th and 72nd hours (P <0.05), indicating that postoperative abdominal pain symptoms of both groups could be effectively improved.
The degree of gastrointestinal reaction of patients showed obvious difference between the 24th and 48th hour and the 24th and 72nd hour (P <0.05). However, there was no huge difference in the degree of gastrointestinal reaction between 72 hours and 48 hours (P >0.05), suggesting
that the gastrointestinal symptoms were improved after 48 hours. In conclusion, postoperative APP could effectively alleviate postoperative pain in patients.
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Affiliation(s)
- Xiaoping Xu
- Department of Hepatobiliary Surgery, Hunan Provincial People’s Hospital (The First Affiliate Hospital of Hunan Normal University), Chansha, Hunan Province, 410005, China
| | - Zeya Shi
- The Nursing Teaching and Research Section, Hunan Provincial People’s Hospital (The First Affiliate Hospital of Hunan Normal University), Chansha, Hunan Province, 410005, China
| | - Honghui Zhang
- Department of Hepatobiliary Surgery, Hunan Provincial People’s Hospital (The First Affiliate Hospital of Hunan Normal University), Chansha, Hunan Province, 410005, China
| | - Wei Sun
- Department of Hepatobiliary Surgery, Hunan Provincial People’s Hospital (The First Affiliate Hospital of Hunan Normal University), Chansha, Hunan Province, 410005, China
| | - Min Zhao
- Department of Hepatobiliary Surgery, Hunan Provincial People’s Hospital (The First Affiliate Hospital of Hunan Normal University), Chansha, Hunan Province, 410005, China
| | - Xiangqun Peng
- The Nursing Teaching and Research Section, Hunan Provincial People’s Hospital (The First Affiliate Hospital of Hunan Normal University), Chansha, Hunan Province, 410005, China
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Watanabe Y, Mochidome N, Nakayama H, Gotoh Y, Setoguchi T, Sunami S, Yoneda R, Ochiai Y, Mizoguchi K, Yamamoto H, Ueki T. Intracholecystic papillary neoplasm associated with invasive carcinoma of the remnant gallbladder after subtotal cholecystectomy: a case report. Surg Case Rep 2022; 8:31. [PMID: 35187597 PMCID: PMC8859015 DOI: 10.1186/s40792-022-01388-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 11/30/2022] Open
Abstract
Background Intracholecystic papillary neoplasm (ICPN) of the gallbladder is a rare tumor and a relatively new concept. Therefore, the natural history and imaging characteristics of ICPN have not yet been fully documented. Moreover, cases who underwent curative resection for remnant gallbladder cancer, including ICPN with associated invasive carcinoma, have been rarely reported. We report a resected case of ICPN of the remnant gallbladder with associated invasive carcinoma for which we could observe a temporal change in imaging findings until malignant transformation. Case presentation A 79-year-old female patient with a surgical history of subtotal cholecystectomy for acute cholecystitis was an ambulatory patient of our institution because of postoperative surveillance for colon cancer. Ultrasonography and computed tomography incidentally detected a small nodule in the cystic remnant gallbladder. The nodule had increased in size 3 months later; thus, additional investigations were performed. Magnetic resonance imaging revealed a 10-mm enhanced nodule without evidence of extraluminal invasion. Diffusion-weighted magnetic resonance imaging revealed restricted diffusion of the lesion, and positron emission tomography revealed marked accumulation in the lesion. The lesion was diagnosed as suspicious for a malignant remnant gallbladder tumor. Therefore, remnant cholecystectomy with gallbladder bed resection was performed. Because preoperative endoscopic retrograde cholangiography revealed a relatively long intact cystic duct, extrahepatic bile duct resection was planned to be omitted. Intraoperatively, the hepatic and duodenal side bile duct where the cystic duct diverged was taped. Using these tapes, which permitted pulling the bile duct, the cystic duct located behind the bile duct could be safely exposed. The lesion was pathologically diagnosed as biliary morphologic ICPN with associated invasive carcinoma. Conclusions Because remnant cholecystectomy is an uncommon procedure and technically difficult, accurate preoperative investigation and surgical planning are important to prevent bile duct injury and omit extrahepatic bile duct resection. In the present case, intracystic change could be detected incidentally at an early stage because of previous remnant gallbladder producing (reconstituting) subtotal cholecystectomy and surveillance for other disease. This case suggests the existence of ICPN that can progress to invasive carcinoma during a short period.
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Affiliation(s)
- Yusuke Watanabe
- Department of Surgery, Hamanomachi Hospital, 3-3-1, Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan.
| | - Naoki Mochidome
- Department of Surgery, Hamanomachi Hospital, 3-3-1, Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
| | - Hiromichi Nakayama
- Department of Surgery, Hamanomachi Hospital, 3-3-1, Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
| | - Yoshitaka Gotoh
- Department of Surgery, Hamanomachi Hospital, 3-3-1, Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
| | - Taro Setoguchi
- Department of Radiology, Hamanomachi Hospital, 3-3-1, Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
| | - Shunya Sunami
- Department of Radiology, Hamanomachi Hospital, 3-3-1, Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
| | - Reiko Yoneda
- Department of Pathology, Hamanomachi Hospital, 3-3-1, Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
| | - Yurina Ochiai
- Department of Surgery, Hamanomachi Hospital, 3-3-1, Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
| | - Kimihisa Mizoguchi
- Department of Surgery, Hamanomachi Hospital, 3-3-1, Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
| | - Hirofumi Yamamoto
- Department of Surgery, Hamanomachi Hospital, 3-3-1, Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
| | - Takashi Ueki
- Department of Surgery, Hamanomachi Hospital, 3-3-1, Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
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Tschuor C, Lyman WB, Passeri M, Salibi PN, Baimas-George M, Iannitti DA, Baker EH, Vrochides D, Martinie JB. Robotic-assisted completion cholecystectomy: A safe and effective approach to a challenging surgical scenario - A single center retrospective cohort study. Int J Med Robot 2021; 17:e2312. [PMID: 34261193 DOI: 10.1002/rcs.2312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/30/2021] [Accepted: 07/09/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Reoperation following a previous subtotal or aborted cholecystectomy presents a challenging surgical scenario that has traditionally required an open completion cholecystectomy. The aim of this study was to describe an institutional experience with a robotic-assisted approach to completion cholecystectomy. METHODS A database was retrospectively audited to identify all patients who underwent robotic-assisted cholecystectomy performed by two hepatopancreatobiliary surgeons at a single centre from 2010 to 2019. RESULTS Twenty six patients who underwent a robotic-assisted completion cholecystectomy were identified. Median operative time was 142 min (48-247 min) with a blood loss of 50 cc (0-500 cc). Minor complications (Clavien-Dindo ≤ II 90 days) occurred in three patients (11.5%) with no major complication or mortality reported. Median hospital length of stay was 1 day (0-6 days) with one patient readmitted. CONCLUSION This study represents to our knowledge the largest series of robotic-assisted completion cholecystectomies to date. The robotic approach appears to be a safe and effective procedure associated with a low morbidity and high success rate.
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Affiliation(s)
- Christoph Tschuor
- Division of HPB Surgery, Department of General Surgery, Atrium Health - Carolinas Medical Center, Charlotte, North Carolina, USA.,Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - William B Lyman
- Division of HPB Surgery, Department of General Surgery, Atrium Health - Carolinas Medical Center, Charlotte, North Carolina, USA
| | - Michael Passeri
- Division of HPB Surgery, Department of General Surgery, Atrium Health - Carolinas Medical Center, Charlotte, North Carolina, USA
| | - Patrick N Salibi
- Division of HPB Surgery, Department of General Surgery, Atrium Health - Carolinas Medical Center, Charlotte, North Carolina, USA
| | - Maria Baimas-George
- Division of HPB Surgery, Department of General Surgery, Atrium Health - Carolinas Medical Center, Charlotte, North Carolina, USA
| | - David A Iannitti
- Division of HPB Surgery, Department of General Surgery, Atrium Health - Carolinas Medical Center, Charlotte, North Carolina, USA
| | - Erin H Baker
- Division of HPB Surgery, Department of General Surgery, Atrium Health - Carolinas Medical Center, Charlotte, North Carolina, USA
| | - Dionisios Vrochides
- Division of HPB Surgery, Department of General Surgery, Atrium Health - Carolinas Medical Center, Charlotte, North Carolina, USA
| | - John B Martinie
- Division of HPB Surgery, Department of General Surgery, Atrium Health - Carolinas Medical Center, Charlotte, North Carolina, USA
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