Overcoming the difficulties in laparoscopic management of contracted gallbladders with gallstones: possible role of fundus-down approach.

Surgical Endoscopy
Shing-Moo HuangWing-Yiu Lui

Abstract

The aim of this study is to compare efficacy and complications between fundus-down and conventional laparoscopic cholecystectomy (LC) in treating contracted gallbladders with gallstones. Between January 1999 and May 2008, 64 patients with contracted gallbladders and gallstones were included in the study. Main outcome measures included conversion rate, complication rate, bile duct injury rate, operation time, and postoperative stay. The average postoperative hospital stay for fundus-down technique was 5 ± 3 days, and 7 ± 3 days for conventional technique (P = 0.003). The conversion rate and complication rate were 0% (0/33) and 3.00% (1/33) for fundus-down technique, and 32.3% (10/31) and 22.6% (7/31) for conventional technique (P = 0.0009 and 0.02, respectively). In subgroup analysis, fundus-down LC seemed to lower the bile duct injury rate from 2/31 (6.5%) to 0/33 (0%) compared with 6/1,468 (0.4%) (P = 0.01 between 6.5% and 0.4% vs. P = 1.00 between 0% and 0.4%). It appears that fundus-down laparoscopic cholecystectomy is associated with lower conversion and complication rates and shorter postoperative hospital stay as compared with conventional laparoscopic cholecystectomy when used to treat patients with contracted gallbladde...Continue Reading

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Citations

Jan 5, 2013·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·D P O'LearyJ C Coffey
Sep 7, 2014·Digestive Diseases and Sciences·Klaus BielefeldtDhiraj Yadav
Oct 27, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Mohamed Mahmood Nasr
May 14, 2020·Surgical Endoscopy·L Michael BruntUNKNOWN Prevention of Bile Duct Injury Consensus Work Group
May 15, 2020·Annals of Surgery·L Michael BruntUNKNOWN and the Prevention of Bile Duct Injury Consensus Work Group
Oct 28, 2017·Journal of Hepato-biliary-pancreatic Sciences·Claudius ConradPatrick Pessaux
Jan 21, 2021·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Maciej Sebastian, Jerzy Rudnicki
Jun 12, 2021·World Journal of Emergency Surgery : WJES·Nicola de'AngelisDaniele Sommacale

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