Subtotal cholecystectomy; A substandard bail-out technique?

Abstract

Introduction: While the open approach was previously mandated as the salvage procedure in difficult cholecystectomies, subtotal cholecystectomy has since been implemented. While this technique may prevent biliary duct injury intraoperatively, it comes with major pitfalls. Case Series: We present a series of four cases where a subtotal cholecystectomy was previously performed, in which further gallstone-related complications occurred. Conclusion: We aim to increase awareness toward recurrent symptoms that may require further evaluation and repeat procedures in patients with previous cholecystectomy; and drawbacks relating to performing subtotal cholecystectomies—opting instead for open cholecystectomy, recruitment of another senior or specialist hepatobiliary surgeon and/or transfer to a tertiary center with the appropriate facilities.