Protocol for laparoscopic cholecystectomy: Is it rocket science?
| Autor: | Takafumi Machimoto, Yusuke Kimura, Masato Naito, Shinji Uemoto, Kiyokuni Nakamura, Masahiro Mizuno, Shigeru Kato, Fumitaka Oike, Daiki Yasukawa, Takahiro Tanaka, Toshiyuki Hata, Yuki Aisu, Yoshio Kadokawa, Maho Sasaki, Tsunehiro Yoshimura, Masaya Nakauchi, Kiyoko Sato, Taku Iida, Tomohide Hori, Daigo Gunji, Hiroaki Furuyama, Yuichiro Takamatsu, Shintaro Yagi |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Critical view of safety Biliary Tract Diseases Hilum (biology) Review 030230 surgery Biliary injury 03 medical and health sciences Laparoscopic cholecystectomy 0302 clinical medicine Blunt dissection Clinical Protocols Risk Factors Protocol Medicine Humans Protocol (science) business.industry Gallbladder General surgery Gastroenterology General Medicine Dissection medicine.anatomical_structure Treatment Outcome Common hepatic duct Cholecystectomy Laparoscopic Elective Surgical Procedures 030211 gastroenterology & hepatology Clinical Competence Patient Safety business Learning Curve |
| Zdroj: | World Journal of Gastroenterology |
| ISSN: | 2219-2840 |
| Popis: | Laparoscopic cholecystectomy (LC) does not require advanced techniques, and its performance has therefore rapidly spread worldwide. However, the rate of biliary injuries has not decreased. The concept of the critical view of safety (CVS) was first documented two decades ago. Unexpected injuries are principally due to misidentification of human factors. The surgeon's assumption is a major cause of misidentification, and a high level of experience alone is not sufficient for successful LC. We herein describe tips and pitfalls of LC in detail and discuss various technical considerations. Finally, based on a review of important papers and our own experience, we summarize the following mandatory protocol for safe LC: (1) consideration that a high level of experience alone is not enough; (2) recognition of the plateau involving the common hepatic duct and hepatic hilum; (3) blunt dissection until CVS exposure; (4) Calot's triangle clearance in the overhead view; (5) Calot's triangle clearance in the view from underneath; (6) dissection of the posterior right side of Calot's triangle; (7) removal of the gallbladder body; and (8) positive CVS exposure. We believe that adherence to this protocol will ensure successful and beneficial LC worldwide, even in patients with inflammatory changes and rare anatomies. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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