Laparoscopic subtotal cholecystectomy: a surgical alternative to reduce complications in complex cases.

INTRODUCTION: Laparoscopic cholecystectomy is a common procedure in general surgery, and in complex cases it is important for the surgeon to know all the alternatives with low associated morbidity. Laparoscopic subtotal cholecystectomy should be considered as an option when a critical view of safety cannot be obtained, because it has a low complication rate and gives the advantages of minimally invasive surgery.

METHODS: Retrospective study of laparoscopic subtotal cholecystectomies in an eight years period.

RESULTS: A total of 1,059 laparoscopic cholecystectomies were performed; 22 were subtotal cholecystectomies, without conversion. Biliary fistula (9%) and intraabdominal collections (4.5%) were the most common complications described. No iatrogenic bile duct injuries or deaths were reported. Our follow-up period was 32months, no recurrences were reported.

CONCLUSIONS: Laparoscopic subtotal cholecystectomy is a safe and effective procedure. It should be considered as an option in complex cases.