IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-9-4-24677 Original Research Paper SUBTOTAL CHOLECYSTECTOMY: A FEASIBLE AND SAFE ALTERNATIVE IN DIFFICULT CASES Chandramaliteeswaran Dr. Lokesh Arora Dr. Sravanti Balaga Dr. April 2020 9 4 01 02 ABSTRACT

INTRODUCTION: In difficult gall bladder, where dissection at calots triangle can’t be done safely, Laparoscopic subtotal cholecystectomy (LSC) has been proposed to avoid injuries while removing major portion of diseased gall bladder. The aim of this retrospective study is to evaluate indication, complications and need of re–intervention after Laparoscopic subtotal cholecystectomy (LSC) METHODS: All the patients who underwent Laparoscopic Subtotal Cholecystectomy from Jan 2016 to Dec 2018 were included. Retrospective analysis of patient’s demographics, laboratory and radiographic investigations, intra–operative findings, complications and need of reintervention was done. RESULTS; Total of 27 patients presented with retroperitoneal tumors. Mean age at presentation was 48.07±13.40. 17(62.96%) out of 27 patients were females. Most common presentation was (18, 66.7%) Pain abdomen, followed by lump abdomen (11,40.7%). Most common tumor in our series is sarcoma, (14.8%). Thirty patientsundergone LSC in study period. Mean age was 51.50 ± 14.45 years. Out of 30, 16 (53.33%) were diabetic. In 13 (43.3%) patients, cystic duct/ residual GB could not be clipped or sutured and hence left alone. Out of these, seven(53.85%) had post–operative bilious drain output. Of these, six (85%) patients had spontaneous resolution of bile leak. Only one patient required post–operative intervention (ERCP). One patient had retained stone in the residual gall bladder, and presented later with pain abdomen, for which completion cholecystectomy was done. CONCLUSION: Subtotal cholecystectomy is a safe alternative procedure in difficult gall bladder, with minimal morbidity of post–operative bile leak with no long term procedure–related morbidity or mortality.