Background: Laparoscopic complete cholecystectomy (LCC) is the preferred and most common method for gallbladder removal. Laparoscopic partial cholecystectomy (LPC) is an alternative approach to LCC when exposure of critical anatomical structures is obscured by inflammation. This study analyzes the outcomes and utilization of laparoscopic partial cholecystectomy compared to complete in academic centers in the US . Methods: By using ICD-9 diagnosis from the University Health System Consortium database, 46,198 laparoscopic cholecystectomies were identified from 2002 to 2005. Of these, 46,094 were complete (99.7%) and 104 partial (0.3%). Demographic and outcome data included: length of stay (LOS), 30-day readmission, mortality, costs and complications. Results: Subgroup analysis revealed that high risk patients who underwent an emergent/urgent cholecystectomy by either approach had similar morbidity (LCC: 14.0 vs. LPC: 19.4%) and mortality (LCC: 0.7 vs. LPC: 0%). There was one leak and one bleeding case (0.05%) in the high risk LPC group while these were increased more than 30-fold after high risk LCC. Conclusion: In academic centers, laparoscopic partial cholecystectomy is rarely used except in the face of major illness and in the urgent/emergent setting. Laparoscopic partial cholecystectomy has comparable incidence of complications with longer length of stay and higher costs. There was a non-significant lower leak, bleeding rate and mortality among the high risk group who underwent urgent/emergent partial cholecystectomy. This data suggests that high risk patients in need of urgent/emergent laparoscopic cholecystectomy may benefit from the partial approach.
Results

Means ± SE; *=p<0.05 by Z-test; **=p<0.05 by t-test.