Safer Laparoscopic Cholecystectomy with Right Posterior Approach Technique: Evaluation of Egyptian Experience

Esayed Elmokadem1, Amr Abdelraouf2* and Osama Abdallah3

1Department of General Surgery, Banha Teaching Hospital, Egypt
2Department of Hepato-Bilio-Pancreatic Surgery, National Hepatology and Tropical Medicine Research Institute (NHTMRI), Egypt
3Department of General Surgery, Shebin Elkom Teaching Hospital, Egypt

^*Correspondance to: Amr Abdelraouf 

 PDF  Full Text DOI: 10.25107/2474-1647.2754

Abstract

Background: More than 600,000 cholecystectomies are being performed laparoscopically each year in United States. Incidence of Bile Duct Injuries (BDI) reported in laparoscopic cholecystectomy ranges from (0.2% to 0.5%) which is higher than the reported injuries in open cholecystectomy (0.1% to 0.2%). Despite of many techniques that were described and many studies designed for dissection of CALOT`S triangle, there is no consensuses about an appropriate or a standard method for dissection that claimed to prevent BDI. All trials are aiming to decrease the number of injuries but no one is superior to other in preventing injury. Methods and Results: The study enrolled 120 patients with symptomatizing chronic calcular cholecystitis. The technique that was done for all patients followed the same principles for dissection of CALOT`s triangle with accomplishing criteria of critical view of safety dissection, but starting from right side or what is called (Right posterior approach). There were 27 patients who expressed very difficult dissection. The GB was punctured in 4 cases with bile and stones leakage occurred. Post-operative pain was tolerable. No recorded cases of major post- operative leak or life threaten morbidities. Conclusion: Dissection of CALOT’s by right posterior approach technique represents one more step for safer laparoscopic cholecystectomy, which is helpful in reduction of morbidities specially the vascular and duct injuries. We recommend this safe technique for junior doctor especially during their steep learning curve.

Keywords

Laparoscopic cholecystectomy; Safe dissection; Safe cholecystectomy; CALOT’s

Cite the article

Elmokadem E, Abdelraouf A, Abdallah O. Safer Laparoscopic Cholecystectomy with Right Posterior Approach Technique: Evaluation of Egyptian Experience. Clin Surg. 2020; 5: 2754..