Table 6.
Comparison of the outcomes of fundus first dissection & subtotal cholecystectomy
| No of LC cases in series | Incidence of FFD/SC | Total conversion rate | Potential conversion without FF/SC | IOC with FFD/SC | Overall complication rate with FFD/SC (%) | Residual CBD stones after FFD/SC (%) | Lap CBD exploration | |
|---|---|---|---|---|---|---|---|---|
| Nassar et al. This study | 5738 | 2.8%/0.08% | 0.49% (+ 3 open from start—0.052%) | 3.5% | 93.8% | 12.6 | 1.2 | Yes |
| Hubert et al. [23] | 500 (elective only) | 7.1% | 2% (+ 52 open from star—9%) | 25.6% | 79.5% | 15.4 | 5.1 | No |
| ElShaer et al. [25] | 1231 |
100% subtotal (meta-analysis) |
8% (+ 19% open from start) | 8% | 4/30 studies | 27 | 3 | No |
| Sormaz et al. [7] | 213 | 6.2%/2.8% | 1.4% (+ 27 open from start excluded—11%) | 0% but 46% of FFD had SC | no | 15 | 7.5 | No |
|
Gupta et al. [24]a (FFD only not SC) |
145 | 18.6% in difficult LC | 2% (excluded fistulas, CBD stones, cancer) | 4.1% | no | 1.5 | 0 | No |
| Tuveri et al. [17] |
1965 (> 72 h AC* excluded) |
1.5% | 3.4% | 20% | 60% | 20 | 6.9 | Yes |
aGupta randomised 31% LC to FFD preoperatively regardless of difficulty and resorted to FFD due to difficulty in an additional 18.6% in the conventional LC group