Surgery today · 2026
Cystic duct management in subtotal cholecystectomy: is closure necessary?
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ishibayashi Kenichi, Kato Kaichiro, Takada Satoshi, Okazaki Mitsuyoshi, Ohbatake Yoshinao, Kitamura Hirotaka, Nakanuma Shinichi, Makino Isamu, Kadoya Shinichi, Yagi Shintaro
Аннотация
PURPOSE: The Tokyo Guidelines 2018 recommend subtotal cholecystectomy (SC) as a bailout procedure for severe cholecystitis; however, closure of the cystic duct orifice (CDO) or remnant gallbladder is not always feasible. We compared the short-term outcomes of SC with and without such closures.
METHODS: A total of 47 patients who underwent SC at two institutions between 2012 and 2022 were included. The patients were classified into closure (CDO or remnant gallbladder closed; n = 35) and non-closure (neither closed; n = 12) groups. The primary outcome was Clavien-Dindo (CD) grade ≥ II complications. Secondary outcomes included intraoperative events, reinterventions, length of stay, and surgery-related mortality rates.
RESULTS: The baseline characteristics were similar. CD grade ≥ II and ≥ III complications occurred in 28.6% vs. 41.7% (p = 0.481) and 11.4% vs. 25.0% (p = 0.350) in the closure vs. non-closure groups, respectively. CD grade ≥ III bile leakage was higher in the non-closure group (5.7% vs. 25.0%, p = 0.097). No intraoperative bile duct injuries occurred. The length of stay was longer in the non-closure group (median [IQR], 27.5 [19.8-33] vs. 7 [5-14.5] days; p < 0.001), and mortality was rare.
CONCLUSION: SC without closure of the CDO or remnant gallbladder may be reserved for carefully selected patients when closure is infeasible or unsafe.
METHODS: A total of 47 patients who underwent SC at two institutions between 2012 and 2022 were included. The patients were classified into closure (CDO or remnant gallbladder closed; n = 35) and non-closure (neither closed; n = 12) groups. The primary outcome was Clavien-Dindo (CD) grade ≥ II complications. Secondary outcomes included intraoperative events, reinterventions, length of stay, and surgery-related mortality rates.
RESULTS: The baseline characteristics were similar. CD grade ≥ II and ≥ III complications occurred in 28.6% vs. 41.7% (p = 0.481) and 11.4% vs. 25.0% (p = 0.350) in the closure vs. non-closure groups, respectively. CD grade ≥ III bile leakage was higher in the non-closure group (5.7% vs. 25.0%, p = 0.097). No intraoperative bile duct injuries occurred. The length of stay was longer in the non-closure group (median [IQR], 27.5 [19.8-33] vs. 7 [5-14.5] days; p < 0.001), and mortality was rare.
CONCLUSION: SC without closure of the CDO or remnant gallbladder may be reserved for carefully selected patients when closure is infeasible or unsafe.