21 February 2017
: Case report
Case Report: Modified Laparoscopic Subtotal Cholecystectomy: An Alternative Approach to the “Difficult Gallbladder”
Unusual clinical course, Unusual setting of medical care, Educational Purpose (only if useful for a systematic review or synthesis)
Michael S. Segal1DEF*, Richard H. Huynh1AEF, George O. Wright1BDDOI: 10.12659/AJCR.900646
Am J Case Rep 2017; 18:186-189
Abstract
BACKGROUND: Laparoscopic cholecystectomy is a commonly performed surgical procedure. In certain situations visualization of the Callot triangle can become difficult due to inflammation, adhesions, and sclerosing of the anatomy. Without being able to obtain the “critical view of safety” (CVS), there is increased risk of damage to vital structures. An alternative approach to the conventional conversion to an open cholecystectomy (OC) would be a laparoscopic subtotal cholecystectomy (LSC).
CASE REPORT: We present a case of a 56-year-old male patient with acute cholecystitis with a “difficult gallbladder” managed with LSC. Due to poor visualization of the Callot triangle due to adhesions, safe dissection was not feasible. In an effort to avoid injury to the common bile duct (CBD), dissection began at the dome of the gallbladder allowing an alternative view while ensuring safety of critical structures.
CONCLUSIONS: We discuss the potential benefits and risks of LSC versus conversion to OC. Our discussion incorporates the pathophysiology that allows LSC in this particular circumstance to be successful, and the considerations a surgeon faces in making a decision in management.
Keywords: Cholecystectomy, Cholecystectomy, Laparoscopic, Gallstones, Laparoscopes
In Press
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.945294
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.945747
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.945539
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.945795
Most Viewed Current Articles
21 Jun 2024 : Case report
88,402
DOI :10.12659/AJCR.944371
Am J Case Rep 2024; 25:e944371
07 Mar 2024 : Case report
49,961
DOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
20 Nov 2023 : Case report
25,080
DOI :10.12659/AJCR.941424
Am J Case Rep 2023; 24:e941424
18 Feb 2024 : Case report
22,629
DOI :10.12659/AJCR.943030
Am J Case Rep 2024; 25:e943030