Outcomes of subtotal cholecystectomy from a large tertiary New Zealand hospital

IF 2.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2026-04-01 Epub Date: 2025-12-17 DOI:10.1016/j.hpb.2025.12.029

Hannah Kim , Jing Goh , Isaac Tranter-Entwistle, Saxon Connor

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引用次数: 0

Abstract

Background

Subtotal cholecystectomy (StC) is a recognised bail-out strategy for difficult cholecystectomy. The aim of the study was to analyse technical aspects and outcomes associated with subtypes of StC.

Method

All perioperative data of patients who underwent StC at Christchurch Hospital between June 2015 to September 2023 were retrospectively identified and analysed. The subtypes were classified as reconstituting (rStC), fenestrating (fStC), and remnant posterior wall (pwStC) subtotal cholecystectomy.

Results

Of the 6251 patients who underwent cholecystectomy, 422 (6.8 %) underwent StC, and 132 (31.3 %), 115 (27.3 %), 175 (41.5 %) underwent rStC, fStC and pwStC respectively.pwStC was generally associated with superior, and fStC inferior outcomes. In patients who had fStC, rStC and pwStC; 38 (33.0 %), 12 (9.1 %), 6 (3.4 %) developed bile leak (p < 0.001), 20 (17.4 %), 12 (9.1 %), 3 (1.7 %) developed intraabdominal collections (p < 0.001), and 28 (24.3 %), 10 (7.6 %) and 9 (5.1 %) required post-operative ERCP (p < 0.001), respectively. No difference in rates of delayed post-op biliary events including cholecystitis and choledocholithiasis were noted across the subgroups (p = 0.775).

Conclusion

There are technical variations of StC with different complication profiles. Surgeons should be aware of these nuances, as it may help inform decision making when faced with need to perform StC.

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新西兰一家大型三级医院胆囊次全切除术的结果。

背景：胆囊次全切除术（StC）是一种公认的困难胆囊切除术的救助策略。该研究的目的是分析与StC亚型相关的技术方面和结果。方法：回顾性分析2015年6月至2023年9月在基督城医院接受StC手术的所有患者围手术期资料。亚型分为重建型（rStC）、开窗型（fStC）和残余后壁型（pwStC）胆囊次全切除术。结果：6251例胆囊切除术患者中，422例（6.8%）行StC，其中rStC 132例（31.3%），fStC 115例（27.3%），pwStC 175例（41.5%）。pwStC通常与预后较好相关，而fStC则与预后较差相关。fStC、rStC和pwStC患者；38例（33.0%）、12例（9.1%）、6例（3.4%）发生胆漏（p < 0.001）、20例（17.4%）、12例（9.1%）、3例（1.7%）发生腹腔内收集（p < 0.001），术后需要ERCP的分别为28例（24.3%）、10例（7.6%）、9例（5.1%）（p < 0.001）。术后迟发性胆道事件（包括胆囊炎和胆管结石）发生率在各亚组间无差异（p = 0.775）。结论：StC有不同并发症的技术变异。外科医生应该意识到这些细微差别，因为它可能有助于在面临需要进行StC时做出决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).