Subtotal Cholecystectomy for Difficult Gall Bladder Due to Chronic Cholecystitis

Subtotal cholecystectomy (STC) is a valuable technique when severe inflammation, fibrosis, or anatomical variations obscure the critical view of safety essential for identifying the cystic duct and artery. It helps reduce the risk of bile duct injuries and other complications that arise during a total cholecystectomy (TC) when these structures are not visible. This study evaluates the safety and outcomes of subtotal cholecystectomy in chronic cholecystitis.

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Key information

Conditions

Gallstone Biliary Tract Diseases Calculi Cholecystolithiasis Cholelithiasis Digestive System Diseases Gallbladder Diseases Gallstones Pathological Conditions, Anatomical Pathological Conditions, Signs and Symptoms

Sex eligibility

All sexes

Study type

Observational

Primary location

Tribhuvan University Teaching Hospital, Kathmandu, Nepal

Kathmandu, 44600, Nepal

About this study

A retrospective analysis was conducted in all patients who underwent a cholecystectomy between May 2021 and November 2024. Indications, complications, and perioperative outcomes of STC were compared with those of standard TC.

The investigators concluded STC is an important bailout procedure in a difficult laparoscopic cholecystectomy associated with higher early postoperative complications but lower bile duct injury.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

Clinical diagnosis of cholelithiasis planned for laparoscopic cholecystectomy
Clinical diagnosis of gallbladder polyp planned for laparoscopic cholecystectomy

Exclusion criteria

Gall bladder malignancy
Cholelithiasis and gallbladder polyp cases managed non-operatively
additional procedures along with cholecystectomy like bile duct exploration, bile duct excision for choledochal cyst.

Treatment and study plan

Cholecystectomy

Procedure

The indications for elective cholecystectomy were symptomatic cholelithiasis, a GB polyp more than ten millimeters, a history of cholecystitis, biliary pancreatitis, or choledocholithiasis. Patients with cholecystitis and severe or moderately severe pancreatitis were operated on after six weeks of the event. Other patients received surgery at the earliest available date. All patients with choledocholithiasis underwent endoscopic retrograde cholangiopancreatography (ERCP) and stone clearance before cholecystectomy. Patients who underwent laparoscopic cholecystectomy were evaluated by surgical and anesthesia teams in outpatient clinics and co-morbid conditions were optimized. Preoperative antibiotic prophylaxis was given to all the patients before induction of anesthesia.

Primary outcomes

postoperative outcomes of subtotal cholecystectomy (STC) and total cholecystectomy (TC)

Time frame: upto 22 months

The primary outcome was to assess the postoperative outcomes of subtotal cholecystectomy (STC) and total cholecystectomy (TC) groups.

Sponsors and collaborators

Lead sponsor

Tribhuvan University Teaching Hospital, Institute Of Medicine.

Other

Registry information

Official study title

Subtotal Cholecystectomy for Difficult Gall Bladder Due to Chronic Cholecystitis: A Cross-sectional Study

Important dates

Study start: 2024
Primary completion: 2025
Study completion: 2025
First posted: May 13, 2025
Registry last updated: May 13, 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.

Published trials that share one or more normalized conditions with this study.

Completed