Safe Surgical Approach to Laparoscopic Cholecystectomy: Posterior Wall Left Cholecystectomy


Creative Commons License

Dişçi E., Peksöz R., Yıldırgan M. İ., Fakirullahoğlu M., Albayrak Y., Kesmez Can F., ...Daha Fazla

The Egyptian Journal Of Hospital Medicine, cilt.87, sa.1, ss.1395-1399, 2022 (Scopus) identifier

Özet

ABSTRACT Background: Laparoscopic Cholecystectomy (LC) is one of the most common surgical procedures. This surgery can be difficult and risky for various reasons. Leaving the posterior wall of the gallbladder (GB) may be a safe option. Objectives: This study aimed to discuss the results of patients who underwent LC with or without leaving the posterior wall of the gallbladder left in situ. Patients and methods: Data of 105 patients who underwent consecutive laparoscopic cholecystectomy between 2017- 2021 were analyzed retrospectively. The patients were divided into groups according to whether the posterior wall of the GB was left in situ and the severity of the sac. The results of 52 patients who underwent standard LC in group 1, 14 patients with normal cholelithiasis and posterior wall left in group 2, 13 patients with elective infection risk and posterior wall left in group 3, and 26 patients with acute cholecystitis and posterior wall left in group 4, were compared. Results: White blood cell (WBC), C-reactive protein (CRP) values of group (3, 4) were statistically higher than the other two groups (p<0.05). There was no statistically significant difference between the groups in terms of postoperative fever, pulse, bile and gallbladder wall cultures, and trocar site infection rates. Conclusion: Standard LC surgery can be performed in uncomplicated cholelithiasis cases. However, in difficult gallbladder cases, leaving the posterior wall of the GB can provide a safe operation. The postoperative results of this patient group were not different from the uncomplicated group. Keywords: Critical view of safety, Difficult cholecystectomy, Gallbladder, Laparoscopy