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

Fundus-First Laparoscopic Cholecystectomy in Difficult Gallbladders: A Retrospective Cross-Sectional Study on a Safe Alternative to Avoid Conversion

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

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

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