Julia F Kohn, BS1, Alexander Trenk, MD2, Woody Denham, MD2, John Linn, MD2, Stephen Haggerty, MD2, Ray Joehl, MD2, Michael Ujiki, MD2. 1University of Illinois at Chicago; NorthShore University HealthSystem, 2NorthShore University HealthSystem
INTRODUCTION: Subtotal cholecystectomy, where the infundibulum of the gallbladder is transected to avoid dissecting within a heavily inflamed triangle of Calot, has been suggested as a method to conclude laparoscopic cholecystectomy while avoiding common bile duct injury. However, some case reports have suggested the possibility of recurrent symptoms from the remnant gallbladder. This retrospective case series reports a minimum of two-year follow-up on patients who underwent subtotal cholecystectomy within one four-hospital system.
METHODS: A retrospective chart review database containing 900 randomly selected cholecystectomies, all of which occurred between 2009 and 2015, was reviewed to identify all instances of subtotal cholecystectomy. Charts for these patients were reviewed through 09/2017, including any documentation from other providers, including primary care.
RESULTS: Six patients who underwent subtotal cholecystectomy with a remnant of infundibulum left following surgery were identified. Surgical approach and the choice to perform subtotal cholecystectomy were dependent on the attending surgeon; all decisions were made intraoperatively. There was an average of 70 months of follow-up for these patients within our institution.
DISCUSSION: This case series adds six cases to the literature surrounding long-term outcomes in patients who underwent subtotal cholecystectomy. Although one patient was lost to follow-up, no patient had recurrent biliary colic or other complications arising from the remnant gallbladder. This may be encouraging to surgeons who feel that subtotal cholecystectomy with an infundibular remnant is the safest way to proceed with cholecystectomy in patients with severe inflammation.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88588
Program Number: P104
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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