Cholelithiasis
Conditions
Keywords
fundus-first laparoscopic cholecystectomy, difficult cholecystectomy, Cross-sectional study, General surgery, Laparoscopic cholecystectomy, Tertiary care hospital
Brief summary
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
Detailed description
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
Interventions
PROCEDUREFundus-First Laparoscopic Cholecystectomy
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.
Standard laparoscopic cholecystectomy technique starting at Calot's triangle. Used as the comparator group in this study.
Sponsors
KANAN ISMAYILZADA, MD
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Conversion Rate to Open Surgery | Intraoperative (during surgery) | Rate of conversion from laparoscopic to open cholecystectomy in each group. Measured as number and percentage of patients converted. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Operative Time | Intraoperative (during surgery) | Total operative time measured in minutes from skin incision to closure. Comparison between the fundus-first and conventional laparoscopic cholecystectomy groups. |
| Postoperative Complication Rate | 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 |
| Length of Hospital Stay | Postoperative hospitalization | Number of days from surgery to discharge. Mean values will be compared between groups. |
Countries
Turkey (Türkiye)
Outcome results
None listed