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NCT Number: NCT07113704

Fundus-First Laparoscopic Cholecystectomy in Difficult Gallbladders: A Safe Alternative Technique

This retrospective cross-sectional study evaluated the safety and effectiveness of the fundus-first laparoscopic cholecystectomy (FFLC) technique in patients with difficult gallbladders. A total of 124 patients who underwent FFLC between 2023 and 2024 were reviewed. The study assessed operative time, intraoperative complications, conversion rates, and postoperative outcomes. The results suggest that FFLC is a safe and feasible approach that can reduce the need for conversion to open surgery in complex cases. The study was conducted at a private hospital in Istanbul, Turkey

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Key information

Conditions

Cholelithiasis Biliary Tract Diseases Digestive System Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Medicana Ataşehir International Hospital

Istanbul, Ataşehir, 34750, Turkey (Türkiye)

About this study

This retrospective study was conducted at a private healthcare institution without a formal IRB. All patient data were anonymised before analysis, and written informed consent was obtained from all patients for the academic use of their clinical data

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients who underwent laparoscopic cholecystectomy at the study center between January 2023 and March 2024
  • Patients diagnosed with difficult gallbladder (Nassar Grade 3-4)
  • Age ≥ 18 years
  • Complete clinical data available for analysis

Exclusion criteria

  • Patients with incomplete medical records
  • Patients undergoing open cholecystectomy from the beginning
  • Patients under 18 years of age

Treatment and study plan

conventional laparoscopic cholecystectomy

Procedure

Standard laparoscopic cholecystectomy technique starting at Calot's triangle. Used as the comparator group in this study.

Other names: Antegrade Laparoscopic Cholecystectomy

Fundus-First Laparoscopic Cholecystectomy

Procedure

Laparoscopic cholecystectomy technique initiated at the gallbladder fundus and carried out retrogradely toward Calot's triangle. This method was applied to difficult gallbladders (Nassar Grade 3-4) to improve operative safety and avoid conversion to open surgery.

Other names: Retrograde laparoscopic cholecystectomy

Primary outcomes

  1. Conversion Rate to Open Surgery

    Time frame: Intraoperative (during surgery)

    Rate of conversion from laparoscopic to open cholecystectomy in each group. Measured as number and percentage of patients converted.

Secondary outcomes

  1. Operative Time

    Time frame: Intraoperative (during surgery)

    Total operative time measured in minutes from skin incision to closure. Comparison between the fundus-first and conventional laparoscopic cholecystectomy groups.

  2. Postoperative Complication Rate

    Time frame: Within 30 days postoperatively

    Includes complications such as wound infection, bile leak, abscess, or any adverse event requiring medical or surgical intervention. Compared between groups

  3. Length of Hospital Stay

    Time frame: Postoperative hospitalization

    Number of days from surgery to discharge. Mean values will be compared between groups.

Sponsors and collaborators

Lead sponsor

KANAN ISMAYILZADA, MD

Other

Registry information

Official study title

Fundus-First Laparoscopic Cholecystectomy in Difficult Gallbladders: A Retrospective Cross-Sectional Study on a Safe Alternative to Avoid Conversion

Important dates

Study start
2023
Primary completion
2024
Study completion
2024
First posted
Aug 11, 2025
Registry last updated
Aug 11, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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