Difficult Laparoscopic Cholecystectomy
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 7
Abstract
Laparoscopiccolecystectomy( L C ) hasdramaticallyreplacedconventional open cholecystectomy [1]. LC was introduced by Mouret in 1987. It is one of the most common procedures being performed by the general surgeons all over the world. With more and more endeavors being made in the field of laparoscopy, more and more complicatedcases, which were relatively contraindicated a few years ago, are now being performed laparoscopically. Advantages of LC are a better cosmesis, shorter hospital stay, shorter recovery time and decreased morbidity [2]. Now a days LC has become the gold standard not only for routine gall bladder removal due to asymptomatic or symptomatic gall stones but also for the treatment of acute gall bladder inflammation [3]. One of the most important aspects of safe LC is a meticulous dissection of the structures in the triangle of Calot. Cystic ductan dcysticartery must be recognised and carefully dissected to prevent intraoperative injury of major bile ductsandrigh the paticartery or excessive intraoperative bleeding. Rate of conversion from laparoscopic to open technique can be minimized by adhering to the basic principles of surgery and keeping in mind the critical anatomy while doing the safe and meticulous dissection [4]. In certain circumstances difficult LC can be expected. Difficult LC can be anticipated based on the pre-operative and intra-operative factors such as old age, male sex, historyof multiple attack so frecent origin or repeated admissions, diabetes mellitus, previous upper abdominal surgery, liver cirrhosis and patients presenting with acute cholecystitis, pancreatitis or cholangitis .
Authors and Affiliations
Jurij Janež
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