Article: In tema di riconoscimento dell'anatomia dell'ilo colecistico in corso di colecistectomia laparoscopica.
2004 Volume 56, Issue 3, Page(s) 389–396
Abstract: Laparoscopic cholecystectomy is widely accepted nowadays as the gold standard in the treatment of cholelithiasis. This new technique was initially associated with a significant increase in morbidity, and in particular in iatrogenic biliary injuries and ... ...
Title translation | Identification of gallbladder pedicle anatomy during laparoscopic cholecystectomy. |
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Abstract | Laparoscopic cholecystectomy is widely accepted nowadays as the gold standard in the treatment of cholelithiasis. This new technique was initially associated with a significant increase in morbidity, and in particular in iatrogenic biliary injuries and arterial haemorrhages, perhaps due to a lack of knowledge of the "laparoscopic anatomy" of the gallbladder pedicle. In this technique the anatomical structures are viewed on a two-dimensional video monitor, and the dissection is performed with long instruments without manual sensitivity. Therefore, the laparoscopic surgeon has to deal with new anatomical views and must be aware of the possible arterial and biliary variants. In this review we describe our technique of laparoscopic cholecystectomy, with particular reference to manoeuvres useful for identifying the various anatomical structures at the gallbladder hilum. In our opinion, it is mandatory to avoid cutting any duct if its identity has yet to be established. For this reason, we pay great attention to the anatomical dissection of Calot's triangle, in order to accurately identify the cystic duct and the cystic artery and any other vascular or biliary structures. Routine intraoperative cholangiography may be useful for identifying the biliary anatomy. When in doubt, the surgeon should not hesitate to convert the procedure to open surgery. |
MeSH term(s) | Biliary Tract/anatomy & histology ; Cholecystectomy, Laparoscopic/adverse effects ; Cholecystectomy, Laparoscopic/instrumentation ; Cholecystectomy, Laparoscopic/methods ; Gallbladder/anatomy & histology ; Gallbladder/blood supply ; Gallbladder/pathology ; Humans |
Language | Italian |
Publishing date | 2004-05 |
Publishing country | Italy |
Document type | English Abstract ; Journal Article ; Review |
ZDB-ID | 603591-7 |
ISSN | 0009-4773 |
ISSN | 0009-4773 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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