Subtotal cholecystectomy: for the difficult @entity101 and XXXX .

@entity1 @entity1085 @entity82 @entity788 @entity101 @entity190 @entity5990 @entity281 @entity2679 @entity1575 @entity1744
An easy, safe, and definitive operation for the " @entity1085 " is described and has been termed subtotal cholecystectomy. Eighteen @entity1 underwent subtotal cholecystectomy during a 30-month period, which constitutes approximately 7% of cholecystectomies performed at our institution. The indications were @entity2679 with severe @entity82 or inflammatory changes that prevented safe dissection in Calot's triangle in 11 @entity1 and portal @entity101 in seven @entity1 ( @entity1575 [two @entity1 ] and segmental portal @entity101 caused by chronic @entity788 [five @entity1 ]) to prevent massive @entity190 from the @entity1085 bed. The operation entails leaving the posterior wall of the @entity1085 attached to the liver and securing the cystic duct at its origin from within the @entity1085 with a purse string technique. The latter obviates the need for dangerous dissection in Calot's triangle. Control of bleeding from the remaining @entity1085 edge is greatly facilitated by the use of a running suture after each stage of piecemeal excision of the @entity1085 . All @entity1 survived the operation and wound @entity281 occurred in only two @entity1 (11%). One @entity1 required a laparotomy 1 month after surgery for adhesive @entity1744 related to the remaining @entity1085 wall and site of a liver biopsy. No @entity1 have so far developed postcholecystectomy symptoms (median follow-up 12.2 months; range 3 to 31 months). Subtotal cholecystectomy is a definitive operation that prevents recurrent @entity5990 formation, as no residual diseased @entity1085 is left in continuity with the biliary system. It provides a simple, safe option in @entity1 in whom cholecystectomy could be hazardous.
