Fundus-First Laparoscopic Cholecystectomy in Difficult Gallbladders: A Safe Alternative Technique

KANAN ISMAYILZADA, MD

Status: Completed

Conditions: Cholelithiasis

Treatments: Procedure: Conventional Laparoscopic Cholecystectomy; Procedure: Fundus-First Laparoscopic Cholecystectomy

Study type: Observational

Funder types: Other

Identifiers

NCT07113704

FFLC2025AMSUKI

Details and patient eligibility

About

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

Full 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

Enrollment: 124 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

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

Trial design

124 participants in 2 patient groups

Conventional Laparoscopic Cholecystectomy

Description:

Patients who underwent standard laparoscopic cholecystectomy, starting dissection at Calot's triangle. This technique served as the comparator for assessing safety and conversion rates relative to the fundus-first approach.

Treatment:

Procedure: Conventional Laparoscopic Cholecystectomy

Fundus-First Laparoscopic Cholecystectomy

Description:

Patients with difficult gallbladders (Nassar Grade 3-4) who underwent laparoscopic cholecystectomy using the fundus-first technique. This approach involved starting dissection at the gallbladder fundus and proceeding retrogradely toward Calot's triangle to improve safety in complex cases.

Treatment:

Procedure: Fundus-First Laparoscopic Cholecystectomy