TPW 7.10 A Review of Previously Abandoned Laparoscopic Cholecystectomies Referred to the Royal Free Hospital

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ID: 324028
2026
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Abstract
Abstract Background Laparoscopic cholecystectomy (LC) is the gold standard for managing symptomatic gallstone disease. A small proportion of cases are abandoned due to operative complexity, requiring referral to specialist centres. This study reviews patients referred to a tertiary HPB unit after abandoned LC, analysing demographics, clinical characteristics, reasons for abandonment, and definitive management outcomes. Methods A retrospective analysis was conducted from September 2023 to September 2025 using a prospectively maintained database. Collected data included demographics, comorbidities, operative details, reasons for abandonment, interval imaging, and outcomes. Continuous variables are reported as mean ± standard deviation or median (range). Results Case volume: 1,290 LCs performed; 34 (2.6%) referred after abandonment Patient characteristics: Median age 65 (32–80) 52.9% female Mean BMI 31.2 ± 5.8 ASA 2–3: 94.1% History of cholecystitis: 91.1% Reasons for abandonment: Dense adhesions, suspected malignancy, cholecystoenteric fistula, distorted anatomy, inflammatory masses Pre-referral management: ERCP 7 (20.6%), CBD stones 7, CBD stenting 2; Interval imaging: MRCP/MRI (n=14), CT (n=7) Timing: Median interval to definitive surgery 190.5 days (18–830) Definitive management: Laparoscopic completion 76.5% (26/34) Conversion to open 14.7% (5/34) Primary open 8.8% (3/34) Operative outcomes: Median operative time 127 min; median LoS 2 days Complications (Clavien-Dindo): 32.4% overall (11/34): grade I 63.6%, grade II 27.3%, grade IIIa 9.1%; 0% 30-day readmission Conclusion Abandoned LC is associated with obesity, ASA 2–3 comorbidities, and complex pathology. Referral to tertiary HPB centers allows safe management, with high laparoscopic completion rates (76.5%) and no readmissions, supporting early referral for challenging cases.
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Authors Zaid Al-Sheikh Ali, Doaa Abdulaziz, Fatima Zulfiqar, Abduljalil Abiri, Hassan Elghonemy, Carlo Ceresa
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.379
URL
https://doi.org/10.1093/bjs/znag087.379
Keywords Keywords not found

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