{"title":"遗弃胆囊切除术:2013-2024年单中心回顾性横断面队列研究","authors":"Raimundas Lunevicius, Stephen W Fenwick","doi":"10.1089/lap.2025.0028","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Abandoned cholecystectomy (AbC) is a rarely studied bailout procedure in gallbladder surgery. This study aimed to estimate the annual utilization rates of AbC, provide AbC-specific clinical outcome data, and discuss AbC-related themes in a broader context. <b><i>Materials and Methods:</i></b> This retrospective cross-sectional study was conducted at a university hospital and comprised patients who underwent AbC between 2013 and 2023. The final follow-up was conducted on January 31, 2024. The dataset was investigated using exploratory data analysis. <b><i>Results:</i></b> In total, 20 female and 17 male patients (mean age, 62.5 years) underwent AbC. The mean AbC rate in the elective surgery setting was 1%. A chronic pericholecystic inflammatory mass was the most common cause of AbC (<i>n</i> = 22; 59.5%). The 30-day postoperative outcomes included a prolonged length of hospital stay (median, 2), readmission rate of 18.9% (four emergencies; three planned), second surgical procedure rate of 13.5% (two emergencies; three planned), and iatrogenic injury rate of 5.4% (2 patients). Long-term outcomes included six emergency admissions with acute biliopancreatic events (16.7%). Fifteen patients underwent elective secondary gallbladder surgeries, including 11 total cholecystectomies, three subtotal cholecystectomies (20%), and one cholecystolithotomy with tube cholecystostomy. <b><i>Conclusions:</i></b> AbC is preventable in most cases. Adherence to guidelines for managing acute calculous cholecystitis is the key. The decision to convert laparoscopic surgery to open or bail out by abandoning cholecystectomy when other options for damage control and limitation surgery are infeasible should be made early to avoid the burden associated with laparoscopic surgery to expose the gallbladder.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Abandoned Cholecystectomy: A Single-Center Retrospective Cross-Sectional Cohort Study, 2013-2024.\",\"authors\":\"Raimundas Lunevicius, Stephen W Fenwick\",\"doi\":\"10.1089/lap.2025.0028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Introduction:</i></b> Abandoned cholecystectomy (AbC) is a rarely studied bailout procedure in gallbladder surgery. This study aimed to estimate the annual utilization rates of AbC, provide AbC-specific clinical outcome data, and discuss AbC-related themes in a broader context. <b><i>Materials and Methods:</i></b> This retrospective cross-sectional study was conducted at a university hospital and comprised patients who underwent AbC between 2013 and 2023. The final follow-up was conducted on January 31, 2024. The dataset was investigated using exploratory data analysis. <b><i>Results:</i></b> In total, 20 female and 17 male patients (mean age, 62.5 years) underwent AbC. The mean AbC rate in the elective surgery setting was 1%. A chronic pericholecystic inflammatory mass was the most common cause of AbC (<i>n</i> = 22; 59.5%). The 30-day postoperative outcomes included a prolonged length of hospital stay (median, 2), readmission rate of 18.9% (four emergencies; three planned), second surgical procedure rate of 13.5% (two emergencies; three planned), and iatrogenic injury rate of 5.4% (2 patients). Long-term outcomes included six emergency admissions with acute biliopancreatic events (16.7%). Fifteen patients underwent elective secondary gallbladder surgeries, including 11 total cholecystectomies, three subtotal cholecystectomies (20%), and one cholecystolithotomy with tube cholecystostomy. <b><i>Conclusions:</i></b> AbC is preventable in most cases. Adherence to guidelines for managing acute calculous cholecystitis is the key. The decision to convert laparoscopic surgery to open or bail out by abandoning cholecystectomy when other options for damage control and limitation surgery are infeasible should be made early to avoid the burden associated with laparoscopic surgery to expose the gallbladder.</p>\",\"PeriodicalId\":50166,\"journal\":{\"name\":\"Journal of Laparoendoscopic & Advanced Surgical Techniques\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-06-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Laparoendoscopic & Advanced Surgical Techniques\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/lap.2025.0028\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Laparoendoscopic & Advanced Surgical Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/lap.2025.0028","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Abandoned Cholecystectomy: A Single-Center Retrospective Cross-Sectional Cohort Study, 2013-2024.
Introduction: Abandoned cholecystectomy (AbC) is a rarely studied bailout procedure in gallbladder surgery. This study aimed to estimate the annual utilization rates of AbC, provide AbC-specific clinical outcome data, and discuss AbC-related themes in a broader context. Materials and Methods: This retrospective cross-sectional study was conducted at a university hospital and comprised patients who underwent AbC between 2013 and 2023. The final follow-up was conducted on January 31, 2024. The dataset was investigated using exploratory data analysis. Results: In total, 20 female and 17 male patients (mean age, 62.5 years) underwent AbC. The mean AbC rate in the elective surgery setting was 1%. A chronic pericholecystic inflammatory mass was the most common cause of AbC (n = 22; 59.5%). The 30-day postoperative outcomes included a prolonged length of hospital stay (median, 2), readmission rate of 18.9% (four emergencies; three planned), second surgical procedure rate of 13.5% (two emergencies; three planned), and iatrogenic injury rate of 5.4% (2 patients). Long-term outcomes included six emergency admissions with acute biliopancreatic events (16.7%). Fifteen patients underwent elective secondary gallbladder surgeries, including 11 total cholecystectomies, three subtotal cholecystectomies (20%), and one cholecystolithotomy with tube cholecystostomy. Conclusions: AbC is preventable in most cases. Adherence to guidelines for managing acute calculous cholecystitis is the key. The decision to convert laparoscopic surgery to open or bail out by abandoning cholecystectomy when other options for damage control and limitation surgery are infeasible should be made early to avoid the burden associated with laparoscopic surgery to expose the gallbladder.
期刊介绍:
Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.