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When feasible, total cholecystectomy is still the operation of choice in the surgical treatment of acute gallbladder disease and subtotal cholecystectomy should not be considered to supplant it. However, when complete removal cannot be safely accomplished, subtotal cholecystectomy recommends itself for consideration to obviate the use of cholecystostomy. Subtotal cholecystectomy incorporates the advantages of total cholecystectomy and has none of the drawbacks of cholecystostomy. A procedure such as cholecystostomy, which is followed by the need for further biliary tract surgery in such a large percentage of cases, leaves much to be desired. In all, excepting the extreme bad risk case in which a drainage operation only is permissible, subtotal cholecystectomy has proved, in my hands, a safe operation, yielding just as satisfactory permanent results as complete cholecystectomy.
Four cases are reported with no mortality and a morbidity comparable to that following total cholecystectomy in the treatment of chronically infected gallbladder with cholelithiasis.
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© 1955 Published by Elsevier Inc.