Introduction:

Review of the current evidence of subtotal cholecystectomy from retrospective studies or non-randomized trials or case series.

Research design:

Narrative Literature Review

Methodology:

With terms Mesh, Subtotal Cholecystectomy, laparoscopic cholecystectomy, published articles relevant to the review topic are identified.

Results:

The prevalence described for performing STC is 1.7 to 13.3% with a clear predominance of emergency surgery. The most frequent indication is Severe Acute Cholecystitis. The average age is between 49 to 69.3 years and in males it is 2.5 times more frequent. Some complication are described in 14 - 45.4% of patients and 6.19% require immediate re-operation. The percentage of bile duct injury is described between 0 and 0.3%. Bile leaks were reported between 12.2% - 19.6%, especially when using fenestrated STC, intra-abdominal abscesses between 2.6% and 7.1%. The conversion rate to open surgery from 7.7% to 50%. Retrograde endoscopic cholangiopancreatography (ERCP) was required in 4.1% to 57.4% due to bile leak. The reported mortality is 0.3 to 0.4% due to sepsis with fistula and multiple organ dysfunction. The average surgical time for STC is 150 minutes.

The 90-day readmission rate was 8.2%.

Conclusion:

STC should not replace TC, however, when necessary, it should assume the complications inherent to this incomplete procedure and should preferably be used only in laparoscopic surgery in its reconstituted variant.