Nigam's Classification of Subtotal Cholecystectomy According to the Level of Resection (NCSC-LR)

Subtotal cholecystectomy is performed in difficult gallbladder where total cholecystectomy is avoided due to risk of bile duct injury and other complications as the structures of Calot’s triangle are difficult to identify due to severe inflammation, fibrosis and dense adhesions. The remnant gallbladder can cause early and late complications such as bile leak, recurrence of stone formation and acute stump cholecystitis. The knowledge of size of remnant gallbladder in advance can help in diagnosis and decision making for handling the remnant gallbladder complications. Nigam’s Classification of Subtotal Cholecystectomy according to the Level of Resection (NCSC-LR) plays an important role in such situations and helps the treating surgeon in diagnosis and treatment of post subtotal cholecystectomy complications by knowing the level of resection (size of remnant gallbladder) as per previous operation notes.