Our Summary

This research paper discusses a study conducted at a District General Hospital to examine the effectiveness of a surgical procedure called laparoscopic subtotal cholecystectomy. This operation is used as an alternative when a surgeon cannot safely view the area they are operating on. The study looked at all of the gallbladder removal surgeries, or cholecystectomies, performed at the hospital over a ten year period.

The surgeries were split into two groups: those performed before the hospital started using the alternative procedure in 2013 and those performed after. The main goal of the study was to see how many patients underwent each type of gallbladder removal surgery: the total removal, the partial removal (subtotal), and the laparoscopic surgery that had to be converted to an open surgery.

The study also looked at side effects like bile leaks, complications, patients who had to return to surgery, and how long patients stayed in the hospital.

The study found that before the hospital started using the alternative procedure, more patients underwent the total removal surgery. However, the alternative procedure appeared to be safe and effective. It reduced the number of laparoscopic surgeries that had to be converted to an open surgery and the length of the hospital stay. Additionally, the rate of patients who had to return for another surgery due to bile leaks was low.

FAQs

  1. What is a laparoscopic subtotal cholecystectomy and when is it used?
  2. What were the results of the study about the adoption of subtotal cholecystectomy in a District General Hospital?
  3. What are the potential complications and outcomes of laparoscopic subtotal cholecystectomy according to the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cholecystectomy is to follow post-operative instructions carefully, including taking prescribed pain medication, resting, and gradually resuming normal activities. It is also important to follow a recommended diet to help prevent complications and aid in the healing process. If any concerning symptoms develop, such as severe abdominal pain, fever, or jaundice, it is important to contact your healthcare provider immediately.

Suitable For

Patients who are typically recommended for cholecystectomy include those with symptomatic gallstones, acute cholecystitis, chronic cholecystitis, choledocholithiasis, and gallbladder polyps. In cases where a critical view of safety cannot be obtained during surgery, laparoscopic subtotal cholecystectomy may be recommended as a safe alternative.

Timeline

Before cholecystectomy:

  • Patient presents with symptoms of gallbladder disease such as abdominal pain, nausea, vomiting, and jaundice
  • Diagnostic tests are conducted to confirm the diagnosis of gallstones or other issues with the gallbladder
  • Patient and healthcare provider discuss treatment options, including cholecystectomy
  • Pre-operative testing and evaluation are completed to ensure the patient is a suitable candidate for surgery

After cholecystectomy:

  • Patient undergoes laparoscopic subtotal cholecystectomy or laparoscopic total cholecystectomy
  • Recovery period involves pain management, monitoring for complications such as bile leak, and gradually resuming normal activities
  • Patient may experience temporary changes in diet and digestion as the body adjusts to the absence of the gallbladder
  • Follow-up appointments are scheduled to monitor healing and address any concerns or complications
  • Overall, laparoscopic subtotal cholecystectomy is shown to be a safe and effective alternative technique, with lower rates of open conversion and shorter hospital stays compared to traditional cholecystectomy procedures.

What to Ask Your Doctor

  1. What are the potential risks and benefits of a laparoscopic subtotal cholecystectomy compared to a laparoscopic total cholecystectomy?
  2. How will the decision to perform a subtotal cholecystectomy be made during the surgery?
  3. What is the likelihood of needing a second surgery or intervention following a laparoscopic subtotal cholecystectomy?
  4. How will my recovery and length of hospital stay differ between a subtotal and total cholecystectomy?
  5. What is the success rate of laparoscopic subtotal cholecystectomy at this hospital based on previous cases?
  6. What alternative treatment options are available for my gallbladder condition?
  7. Will I need any additional follow-up care or monitoring after the surgery if I have a subtotal cholecystectomy?
  8. How will a laparoscopic subtotal cholecystectomy affect my long-term digestive health and quality of life?
  9. Are there any specific dietary or lifestyle changes I should make after a subtotal cholecystectomy?
  10. Can you provide me with more information or resources about laparoscopic subtotal cholecystectomy?

Reference

Authors: Boyd K, Bradley NA, Cannings E, Shearer C, Wadhawan H, Wilson MSJ, Crumley A. Journal: HPB (Oxford). 2022 May;24(5):759-763. doi: 10.1016/j.hpb.2021.10.003. Epub 2021 Oct 22. PMID: 34776369