submucous cholecystectomy for acute calcular cholecystitis

ABSTRACT

The submucous cholecystectomy a definite, safe and easy operation that removes the gallbladder except part of the muscular coat in contact with the liver, is proposed for acute on top of chronic calcular cholecystitis with hydrops/empyema, when dissection in Calot's triangle is hazardous. Histological examination of the excised gallbladder specimens, using both the routine hematoxylin and eosin and Masson trichrome stains, proved the presence of a definite plane of cleavage. This plane of cleavage between the acutely inflamed, edematous and hemorrhagic mucosa and the rest of the gallbladder wall exists at the level of the superficial submucosa. The inflammatory edema creates a sort of a potential space making blunt surgical dissection in this plane easy and bloodless