TITLE:
Bipartite Laparoscopic Cholecystectomy: New Technique for Avoiding Bile Duct Injury in Difficult Cases
AUTHORS:
Ahmed E. Lasheen, Khaled Safwat, Wesam Amr, Osama Gharib, Mostafa Baiomy, Mohamed Riad, Basem Sieda
KEYWORDS:
Bipartite Laparoscopic Cholecystectomy, Difficult Cases
JOURNAL NAME:
Surgical Science,
Vol.5 No.6,
June
20,
2014
ABSTRACT: The incidence of bile duct
injury in laparoscopic cholecystectomy (LC) is still two times greater compared
to classic open surgery. This study offers new procedure to avoid this
complication during LC. The gall bladder was divided into two parts above the
Hartmann pouch and all contents were aspirated. Then, the distal part was
dissected for short distance. The proximal part was dissected dome down until
reaching to cystic duct which was tied or clipped and cut. J-vac drain was put
in peritoneal cavity. Between September 2012 and October 2013, overall 77
patients (53 females and 24 males) with mean age of 49 years (between 23 and 67
years) underwent bipartite laparoscopic cholecystectomy. The mean operative
time was 60 minutes (between 40 and 90 minutes). The dissection of both parts
of gall bladder was safe and easy as close as possible from its wall. No
biliary tract injuries were recorded during or after procedure and also at
follow-up period (20 months). Bipartite laparoscopic cholecystectomy is safe,
easy to do, and can avoid all complications especially bile duct injuries in
difficult cases.