How to Minimise Bile Duct Injury in Laparoscopic Cholecystectomy

Abstract

Background: Most commonly used technique for laparoscopic cholecystectomy i.e., Infundibular technique allows for circumferential dissection of cystic duct and gall bladder junction which creates a flaring tunnel shape. Aim: To evaluate CVS(critical View of safety)in laparoscopic cholecystectomy. Place: Aadil Hospital and Avicenna Medical College and Hospital Bedian Road Lahore. Methods: A retrospective analysis of a 2 year practice in our surgical unit has been conducted. We routinely practiced CVS cholecystectomy. Patients having previous abdominal surgery, recurrent chronic disease, possible bile duct stones and liver disease were excluded. Results: There were total of 120 patients in this study. 81(67.5%) females and 39 (32.5%) males who had surgery following CVS technique. 34 (28.3%) had acute/chronic cholecystitis or dense adhesions. Conclusion: CVS should be achieved before applying clips. In case of difficulty in achieving the desired objective one should consider cholangiography or conversion to open cholecystectomy.