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 SS  Vol.5 No.6 , June 2014
Bipartite Laparoscopic Cholecystectomy: New Technique for Avoiding Bile Duct Injury in Difficult Cases
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.
Cite this paper: Lasheen, A. , Safwat, K. , Amr, W. , Gharib, O. , Baiomy, M. , Riad, M. and Sieda, B. (2014) Bipartite Laparoscopic Cholecystectomy: New Technique for Avoiding Bile Duct Injury in Difficult Cases. Surgical Science, 5, 252-257. doi: 10.4236/ss.2014.56044.
References

[1]   Mrksic, M.B., Farkas, E., Cabafi, Z., Komlos, A. and Sarac, M. (1999) Complications in Laparoscopic Cholecystectomy. Medicinski Pregled Journal, 52, 253-257.

[2]   Gronroos, J.M., Hamalainen, M.T., Karvonen, J., Gullichsen, R. and Laine, S. (2003) Is Male Gender a Risk Factor for Bile Duct Injury during Laparoscopic Cholecystectomy? Langenbeck’s Archives of Surgery, 388, 261-264. http://dx.doi.org/10.1007/s00423-003-0407-1

[3]   Ahrendt, S.A. and Pitt, H.A. (2001) Surgical Therapy of Iatrogenic Lesions of Biliary Tract. World Journal of Surgery, 25, 1360-1365. http://dx.doi.org/10.1007/s00268-001-0124-2

[4]   Archer, S.B., Brown, D.W., Smith, C.D., Branum, G.D. and Hunter, J.G. (2001) Bile Duct Injury during Laparoscopic Cholecystectomy. Results of National Survey. Annals of Surgery, 234, 549-559.
http://dx.doi.org/10.1097/00000658-200110000-00014

[5]   Flum, D.R., Koepsell, T., Heagerty, P., Sinanan, M. and Dellinger, E.P. (2001) Common Bile Duct Injury during Laparoscopic Cholecystectomy. Adverse Outcome or Preventable Error? Archives of Surgery, 136, 1287-1292. http://dx.doi.org/10.1001/archsurg.136.11.1287

[6]   Tsaalis, K.G., Chritoforidis, E.C., Dimitriadis, C.A., Kalfadis, S.C., Botsios, D.S. and Daduokis, J.D. (2003) Management of Bile Duct Injury during and after Laparoscopic Cholecystectomy. Surgical Endoscopy and Other Interventional Techniques, 17, 31-37. http://dx.doi.org/10.1007/s00464-001-9230-3

[7]   Hobbs, M.S., Mai, Q., Knuiman, M.W., Fletcher, D.R. and Ridout, S.C. (2006) Surgeon Experience and Trends in Intraoperative Complications in Laparoscopic Cholecystectomy. British Journal of Surgery, 93, 844-849. http://dx.doi.org/10.1002/bjs.5333

[8]   Nuzzo, G., Giuliante, F., Giovannini, I., Ardito, F., D’Acapito, F., Vellone, M., Murazio, M. and Capelli, G. (2005) Bile Duct Injury during Laparoscopic Cholecystectomy: Results of an Italian National Survey on 56 591 Cholecystectomies. Archives of Surgery, 140, 986-989.
http://dx.doi.org/10.1001/archsurg.140.10.986

[9]   Calvete, J., Sabater, L., Camps, B., Verdu, A., Gomez-Portilla, A., Tonico, M.A., Flor, B., Cassinello, N. and Lledo, S. (2000) Bile Duct Injury Laparoscopic Cholecystectomy. Myth or Reality of the Learning Curve? Surgical Endoscopy, 14, 608-611. http://dx.doi.org/10.1007/s004640000103

[10]   Johnson, S.R., Koehler, A., Pennington, I.K. and Hanto, D.W. (2000) Long-Term Results of Surgical Repair of Bile Duct Injuries Following Laparoscopic Cholecystectomy. Surgery, 128, 668-677.
http://dx.doi.org/10.1067/msy.2000.108422

[11]   Olsen, D. (1997) Bile Duct Injuries during Laparoscopic Cholecystectomy. Surgical Endoscopy, 11, 133-138. http://dx.doi.org/10.1007/s004649900315

[12]   Krahenbuhl, L., Sclabas, G., Wente, M.N., Schafer, M., Schlumpf, R. and Buchler, M.W. (2001) Incidence, Risk Factors and Preventin of Biliary tract Injuries Laparoscopic Cholecystectomy in Switzerland. World Journal of Surgery, 25, 1325-1330. http://dx.doi.org/10.1007/s00268-001-0118-0

[13]   Fullum, T.M., Downing, S.R., Ortega, G., Chang, D.C., Oyetunji, T.A., Kirk, K.V., Tran, D.D., Wood, I., Cornwell, E.E. and Tuner, P.L. (2013) Is Laparoscopy a Risk Factor for Bile Duct Injury during Cholecystectomy? Journal of the Society of Laparoendoscopic Surgeons, 17, 365-370.
http://dx.doi.org/10.4293/108680813X13654754535638

[14]   Hunter, J.G. (1991) Avoidance of Bile Duct Injury during Laparoscopic Cholecystectomy. The American Journal of Surgery, 162, 71-76. http://dx.doi.org/10.1016/0002-9610(91)90207-T

[15]   Strasberg, S.M. (2002) Avoidance of Biliary Injury during Laparoscopic Cholecystectomy. Journal of Hepato-Biliary-Pancreatic Surgery, 9, 543-547. http://dx.doi.org/10.1007/s005340200071

[16]   Kato, K., Matsuda, M., Onodera, K., Kobayashi, T., Kasai, S. and Mito, M. (1994) Laparoscopic Cholecystectomy from Fundus Downward. Surgical Laparoscopy & Endoscopy Journal, 4, 373-374. http://dx.doi.org/10.1097/00019509-199410000-00012

[17]   Sari, Y.S., Tunali, V., Tomaoglu, K., Karagoz, B., Guney, A.I. and Karago, I.Z. (2005) Can Bile Duct Injuries Be Prevented? A New Technique in Laparoscopic Cholecystectomy. BMC Surgery, 5, 14-17. http://dx.doi.org/10.1186/1471-2482-5-14

[18]   Giger, U., Ouaissi, M., Schmitz, S.f., Krahenbuhl, S. and Krahenbuhl, L. (2011) Bile Duct Injury and Use of Cholangiography during Laparoscopic Cholecystectomy. British Journal of Surgery, 3, 391-396.
http://dx.doi.org/10.1002/bjs.7335

[19]   Zha, Y., Chen, X.R., Luo, D. and Jin, Y. (2010) The Prevention of Major Bile Duct Injuries in Laparoscopic Cholecystectomy: Experience with 13,000 Patients in a Single Center. Surgical Laparoscopy Endoscopy and Percutaneous Techniques, 6, 373-383.

[20]   Machado, N.O. (2011) Biliary Complications Post Laparoscopic Cholecystectomy: Mechanism, Preventive Measures, and Approach to Management: A Review. Diagnostic and Therapeutic Endoscopy Journal, 12, 1155-1164.

 
 
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