Bipartite Laparoscopic Cholecystectomy: New Technique for Avoiding Bile Duct Injury in Difficult Cases
- 1 General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt
- 2 General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt
- 3 General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt
- 4 General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt
- 5 General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt
- 6 General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt
- 7 General and Laparoscopic Surgery Department, Zagazig University Hospital, Zagazig University, Zagazig, Egypt
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.
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