Fenestrating and Reconstituting Subtotal Cholecystectomy Are Safe and Effective

Gross A, Hong H, Hossain MS, et al. Clinical and Patient-Reported Outcomes Following Subtotal Cholecystectomy: 10-Year Single-Institution Experience. Surgery. 2024; in press.

This article reported data from a retrospective, single-institution study that sought to clarify long-term outcomes of subtotal cholecystectomy (SC).

Patients undergoing SC (n = 218) were identified by reviewing operative notes. Fenestrated SC was performed in 113 patients, and reconstituting SC was the chosen procedure in 105 patients. The median follow-up interval was 63 months, and complete data were available for 38.9% of patients.

The analysis showed that rates of complications (bile duct injury, bile leak, readmission within 30 days) were <10% and similar in both groups. Bile leak was significantly reduced when cystic duct closure was included in the fenestrated SC procedure. Complications were significantly reduced in patients who had SC completed laparoscopically.

Long-term data showed that 92% of patients were pain free, had no postoperative nausea, or vomiting, and reported good quality of life. Of note was the finding that 32% of respondents reported dietary restrictions. Completion cholecystectomy was performed in 0.9% of patients.

The authors concluded that fenestrated and reconstituted SC were equally safe and effective. They recommended laparoscopic SC with cystic duct closure because of reduced risk of complications.