scholarly journals Visualization of biliary ducts while doing laparoscopy, using HEV LapVision

2018 ◽  
Vol 85 (4) ◽  
pp. 9-11
Author(s):  
О. V. Ogurtsov ◽  
О. V. Lukavetskyy
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Cystic Duct ◽  
Simple Procedure ◽  
Biliary Tree ◽  
High Energy ◽  
Biliary Duct ◽  
Critical View ◽  
Fluorescent Cholangiography ◽  
Biliary Ducts ◽  
Intraoperative Visualization

Objective. To determine efficacy of intraoperative visualization of biliary tree, using fluorescent cholangiography (FCH) and a high–energy visible laparoscopy vison (HEV LapVison) while laparoscopic cholecystectomy performance (LCHE). Маterials and methods. In 25 patients LCHE was performed. Preoperatively fluorescein was injected intravenously for guaranteeing of the FCH performance. HEV LapVison was applied for intraoperative visualization of fluorescence. Results. Visualization of the cystic duct and its inflow into common biliary duct was guaranteed in 90% patientsх. In 13 (52%) patients the anatomic picture was typical while in 7 (28%) some variants were observed: a parallel course of cystic duct and common biliary duct, and low level of the cystic duct inflow into hepaticocholedochus. Conclusion. FCH is a simple procedure for intraoperative navigation doing and guaranteeing of «critical view on security» while performance of LCHE. FCH together with HEV LapVison constitutes a new surgical procedure, making possible revealing of extrahepatic biliary ducts. This method may be applied as additional one while doing LCHE, preventing damage of biliary ducts.

EP.TH.665Where’s the gallbladder? A rare case of gallbladder agenesis with cystic duct stone

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Tiffany Cheung ◽  
Roberto Presa ◽  
Antonio Manzelli
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Cystic Duct ◽  
De Novo ◽  
Stone Formation ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Filling Defect ◽  
Biliary Colic ◽  
Biliary Duct ◽  
Increased Risk ◽  
Gallbladder Agenesis

Abstract Aims Gallbladder agenesis is a rare congenital anatomical malformation with an incidence of 0.007-0.0027%. Although usually asymptomatic, clinically it may present similarly to biliary colic. There may be increased risk of de novo biliary duct stone formation due to biliary dyskinesia, subsequent duct dilatation and biliary stasis. We present a case of incidental gallbladder agenesis identified during intended laparoscopic cholecystectomy. Methods A 68 year-old female with no significant comorbidities presented with a 16 hour history of colicky right upper quadrant pain and vomiting. She had been awaiting cholecystectomy for increasingly symptomatic gallstones, most recently visualised within a contracted gallbladder on ultrasound two months prior. Recurrently obstructive LFT’s warranted urgent magnetic resonance cholangiopancreatography (MRCP), which identified a poorly-visualised contracted gallbladder and a 10mm common bile duct without filling defect. At index laparoscopic cholecystectomy, a very small thick-walled structure resembling the gallbladder was identified and safely excised in retrograde; a stone was seen within. Results Macroscopic examination revealed a 27 x 9 x 11mm piece of dark brown tissue containing soft orange material. Microscopic histological examination confirmed this to be cystic duct focally lined by mucinous epithelium with chronic inflammation. Findings were consistent with gallbladder agenesis. Conclusions Although rare, it is important for surgeons to maintain an index of suspicion for gallbladder agenesis, particularly if repeated imaging demonstrates a poorly-visualised or ‘contracted’ gallbladder despite adequate fasting. Furthermore, as in this case, the presence of ‘gallbladder’ stones radiologically does not preclude gallbladder agenesis. Anticipation of this malformation may aid interpretation of biliary anatomy, if incidentally found intra-operatively.

Optimizing the critical view of safety in laparoscopic cholecystectomy by clipping and transecting the cystic artery before the cystic duct

2007 ◽  
Vol 94 (4) ◽  
pp. 473-474 ◽  
Author(s):  
A. R. Wijsmuller ◽  
M. Leegwater ◽  
L. Tseng ◽  
H. J. Smaal ◽  
G. J. Kleinrensink ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Cystic Duct ◽  
Cystic Artery ◽  
Critical View ◽  
Critical View Of Safety

Fluorescent cholangiography illuminating the biliary tree during laparoscopic cholecystectomy

2010 ◽  
Vol 97 (9) ◽  
pp. 1369-1377 ◽  
Author(s):  
T. Ishizawa ◽  
Y. Bandai ◽  
M. Ijichi ◽  
J. Kaneko ◽  
K. Hasegawa ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Biliary Tree ◽  
Fluorescent Cholangiography

scholarly journals Near-infrared fluorescent cholangiography – real-time visualization of the biliary tree during elective laparoscopic cholecystectomy

HPB ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 538-545 ◽  
Author(s):  
Antonio Pesce ◽  
Saverio Latteri ◽  
Martina Barchitta ◽  
Teresa R. Portale ◽  
Biagio Di Stefano ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Real Time ◽  
Near Infrared ◽  
Biliary Tree ◽  
Fluorescent Cholangiography ◽  
Real Time Visualization ◽  
Elective Laparoscopic Cholecystectomy

scholarly journals Acute Care Surgeon: Use of the Endo GIA Stapler for Cystic Duct Ligation in Emergent Cholecystectomy

2017 ◽  
Vol 6 (1) ◽  
pp. 44-48
Author(s):  
Vicente Gracias ◽  
Paul Truche ◽  
David Blitzer ◽  
Erin Scott ◽  
Joseph Hanna
Keyword(s):  
Logistic Regression ◽  
Laparoscopic Cholecystectomy ◽  
Acute Care ◽  
Cystic Duct ◽  
Open Surgery ◽  
Postoperative Morbidity ◽  
Biliary Duct ◽  
Conversion To Open Surgery ◽  
Duct Ligation ◽  
Ed Visits

ABSTRACT Introduction Endo GIA stapler use is a method to ligate cystic ducts during laparoscopic cholecystectomy in the elective and emergent setting. Its use has not been widely described in the acute care surgery (ACS) setting. Our study aims to determine factors predicting Endo GIA use by acute care surgeons and evaluate when applied its safety and efficacy in emergent cholecystectomy. Additionally, we investigate the use of Endo GIA stapler with respect to conversion to open surgery, reduction in postoperative morbidity, and impact on length of stay in an ACS setting. Materials and methods A retrospective chart review was conducted for laparoscopic cholecystectomy performed by ACS in a public university training hospital over 1 year. Variables associated with Endo GIA stapler use were identified through multivariate logistic regression and subsequently, assessed after optimizing the model to control for confounding effects. Results Of the 118 laparoscopic cholecystectomies performed, the Endo GIA Stapler was used for cystic duct ligation in 20 cases. Surgeons’ dictated reason for stapler use included dilated cystic duct (45%), short cystic duct remnant (15%), inadequate room for clip ligation and division (10%), and nonspecific (45%). Patient demographic variables for Endo GIA stapled and clipped groups were not significantly different. Logistic regression revealed a significantly higher likelihood of Endo GIA stapler use in patients with comorbid biliary duct disease, preoperative endoscopic retrograde cholangiopancreatography (ERCP), and a trend towards significance in patients with previous emergency department (ED) visits. There was no significant difference in conversion to open surgery, postoperative morbidity, and postoperative length of stay. Conclusion Comorbid biliary duct disease, previous ED visits, and preoperative ERCP are predictive of patients requiring use of the Endo GIA stapler for cystic duct ligation during emergent cholecystectomy. The use of Endo GIA stapler by Acute Care Surgeons is safe and effective. How to cite this article Truche P, Blitzer D, Scott E, Hanna J, Gracias V, Peck G. Acute Care Surgeon: Use of the Endo GIA Stapler for Cystic Duct Ligation in Emergent Cholecystectomy. Panam J Trauma Crit Care Emerg Surg 2017;6(1):44-48.

SP6.1.6 Rule of systematic intraoperative cholangiogram in patients undergoing emergency cholecystectomy

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Fady Hatem ◽  
Sam Mostafa ◽  
Jenny Thomas ◽  
Ahmad Nassar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Cystic Duct ◽  
Gall Stone ◽  
Stone Disease ◽  
Cbd Stones ◽  
Gall Stones ◽  
Gall Stone Disease ◽  
Biliary Ducts ◽  
Emergency Cholecystectomy

Abstract Aims Incidence of gall stone disease is estimated at 10-15%of population. Intraoperative cholangiography (IOC) diagnose choledocholithiasis, delineates the anatomy of the biliary ducts, facilitate the dissection and reduces injuries. Our aim is to assess the feasibility and role of IOC and the incidence of choledocholithiasis in acute cholecystitis (ACC). Methods Retrospective analysis of prospectively collected data for patients admitted with ACC and undergoing same-hospital-stay laparoscopic cholecystectomy (LC). IOC was systematically attempted in all cases. Results 475cases included. Female to male ratio1.9:1. Conversion to open was done in 3 cases. Preoperative cholelithiasis was confirmed in 439cases versus 34cases with no stones. USS CBD abnormality (dilated or contain stone) found in 53 cases, out of which 8(15%) cases had CBD stones. Jaundice was found in 69cases, where 25(39%) cases had confirmed choledocholithiasis. IOC was successful in all cases except one. Abnormal IOC was found in 99(21%) cases. Of those; CBD stones were confirmed in 76 (77%) cases regardless the presence of cholelithisasis on USS. Empyema was found in 237 cases and it was associated with higher risk of abnormal IOC in 59(25%) cases where CBD stones were confirmed in 45(76%) cases. Cystic duct (CD) stones found in 80cases, of those 27(34%)cases had choledocholithiasis. Conclusions Females have double the risk of ACC. Preoperative jaundice and CD stones are stronger indicators than CBD diameter for presence of choledocholithiasis. The incidence of choledocholithiasis in ACC is (20-25%) regardless the presence of gall stones on USS. IOC is feasible and highly recommended in emergency LC.

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