Half dome down versus subtotal cholecystectomy in difficult laparoscopic cholecystectomy : A retrospective study

Background: Laparoscopic cholecystectomy can be challenging in certain cases. This study aimed to compare outcomes between half dome-down cholecystectomy and subtotal cholecystectomy in difficult laparoscopic procedures.Methods: This retrospective study included 60 patients undergoing laparoscopic cholecystectomy. Patients were divided into two equal groups: half dome-down (Group I) and subtotal cholecystectomy (Group II). Operative details, postoperative complications, and hospital stay were analyzed. Results: Operative time, blood loss, and intraoperative difficulties were comparable between groups. Total postoperative complications were significantly lower in Group I compared to Group II (16.67% vs 43.33%, p=0.047). Port site infection was the most common complication in Group II (16.67%). Hospital stay was significantly shorter in Group I ompared to Group II (3.57 ± 1.25 days vs 4.33 ± 0.99 days, p=0.011). No mortality occurred in either group.Conclusions: Both half dome-down and subtotal cholecystectomy techniques are viable options for difficult laparoscopic cholecystectomies. However, the half dome-down approach demonstrated advantages in terms of lower postoperative complication rates and shorter hospital stays, without compromising operative outcomes. These findings suggest that the half dome-down technique may be preferable in managing challenging gallbladder cases.