Subtotal Cholecystectomy I In Liver Cirrhosis And Acute Cholecystitis I (Transverse & Longitudinal ) 1

Abstract

An easy, safe and definitive operation for the "difficult gallbladder" is described and has been termed subtotal cholecystectomy. Fifty patients suffering from cholecystitis were included in this study. The patients were classified into two groups according to the type of cholecystitis, associated liver cirrhosis and subsequent method of management .Group (A) included 20 patients with acute cholecystitis. Group (B) included 30 patients with liver cirrhosis, 25 patients of them suffered from chronic calcular cholecystitis and 5 patients suffered from acute cholecystitis in cirrhotic patients. The operation entails leaving the posterior wall of the gallbladder attached to the liver and securing the cystic duct at its origin from . within the gallbladder with a purse string technique. The later obviates the need for dangerous dissection in Colot's triangle . Control of bleeding from the remaining gllabladder edge is greatly facilitated by the use of running sture after each stage of piecemeal excision of the gallbladder.