Laparoscopic Completion Cholecystectomy After Prior Laparoscopic Subtotal Cholecystectomy: at Times a Necessary Evil?

Talar Tatarian1, Francesco Palazzo1, L. Michael Brunt2, Daniel Deziel3, Steven Strasberg2, Michael Pucci1. 1Thomas Jefferson University, 2Washington University, 3Rush University

Laparoscopic cholecystectomy is a common procedure.  The incidence of major bile duct injury is greater than in open cholecystectomy.  The critical view of safety is a secure method of ductal identification.  When this is not acheivable, total cholecystectomy should not be performed and a bail-out procedure should be utilized.  Once such procedure is a subtotal cholecystectomy with two subtypes depending on whether the gallbladder is "reconstituted" or "fenestrated."  We report a case of recurrent biliary colic after a reconstituting subtotal cholecystectomy requiring laparoscopic completion cholecystectomy.

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