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Original Article
 
Laparoscopic partial cholecystectomy: A way of getting out of trouble
Peter Daechul Yoon1,2, Tony Pang1,2, Mehan Siriwardhane1,2, Arthur Richardson1,2, Michael Hollands1,2, Henry Pleass1,2, Emma Johnston1,2, Lawrence Yuen1,2, Vincent Lam1,2
1Department of Surgery, Westmead Hospital, Cnr Hawkesbury Road and Darcy Road, Westmead NSW 2145, Australia Sydney, Australia.
2Discipline of Surgery, Sydney Medical School, the University of Sydney, Australia.

Article ID: 100057IJHPDPY2016
doi:10.5348/ijhpd-2016-57-OA-13

Address correspondence to:
Dr. Peter Daechul Yoon
Department of Surgery, Westmead Hospital
Cnr Hawkesbury Road and Darcy Road
Westmead NSW 2145, Australia Sydney
Australia

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How to cite this article
Yoon PD, Pang T, Siriwardhane M, Richardson A, Hollands M, Pleass H, Johnston E, Yuen L, Lam V. Laparoscopic partial cholecystectomy: A way of getting out of trouble. Int J Hepatobiliary Pancreat Dis 2016;6:68–75.


Abstract
Aims: Laparoscopic cholecystectomy (LC) is currently the standard treatment for symptomatic gallstones. In the presence of moderate to severe inflammation when dissection of the cholecystohepatic triangle cannot be safely achieved, laparoscopic partial cholecystectomy (LPC) has been proposed as an alternative to open conversion to prevent bile duct injuries. The aim of this study is to review our experience of the technique.
Materials and Methods: A retrospective review of all patients who underwent laparoscopic cholecystectomy under the upper gastrointestinal surgical unit at Westmead Hospital was undertaken. The study included all emergency and elective cases during a period from February 2012 to February 2014. Demographic, clinical, operative and postoperative characteristics including operative technique, placement of a drain, complications, length of hospital stay and histopathology were collected.
Results: A total of 404 patients underwent LC during the two year study period of which 23 were LPC's. Patients who underwent LPC tended to be older and more likely of the male gender. These patients were also more likely to be an emergency operation and have a higher ASA grade compared to the LC group. Length of stay and operative time tended to be longer. There were five (22%) bile leaks postoperatively and all were successfully managed with postoperative ERCP and stenting. The major complication rate was 35% (8/23) with no bile duct injury or perioperative mortality.
Conclusion: This current case series adds further evidence to suggest that LPC is a viable alternative to conversion in cases of difficult LC.

Keywords: Cholecystitis, Laparoscopic cholecystectomy, Partial cholecystectomy, Subtotal cholecystectomy


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Author Contributions:
Peter Daechul Yoon – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Tony Pang – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Mehan Siriwardhane – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Arthur Richardson – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Michael Hollands – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Henry Pleass – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Emma Johnston – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Lawrence Yuen – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Vincent Lam – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Peter Daechul Yoon et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.