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  • Metode varne laparoskopske holecistektomije : prikaz primera = Principles of safety in laparoscopic cholecystectomy : case report
    Benedik, Tomaž
    Background. Biliary injuries are the most serious complications of laparoscopic cholecystectomy. Injury rate was from some reports 2, 5 to 4 times higher than with open operation. There are many ... proposed . classifications of types of biliary injuries. In the article Strasberg classication is introduced. The most frequent direct cause of laparoscopic biliary injury is misidentification of the common bile duct. This mistake happens often in easy laparoscopic cholecystectomy. lu the article, a laparoscopic operative technique, termed as "window ", is introduced for preventing laparoscopic biliary injuries in a case of easy laparoscopic cholecystectomy. Methods. To avoid misidentification of the ducts, one should conclusively identify the cystic duct and artery, the structures to be dividedin every laparoscopic cholecystectomy. To achieve that goal, Calot's triangle must be dissected free of fat and fibrous tissue and the lower end ofthe gallbladder must be dissected of the liver bed. The only two structures entering the gallbladder should be visible cystic duct and artery. Blind application of cautery and clips to control bleeding should be avoided due to the risk of injuring the bile duct. Low cautery settings should be used in portal dissections to prevent arc. Case. 41-year old female with one year history of colic biliary paiu and US-confirmed 17 mm and 3 mm gallbladder stones was admitted in ward because of elective laparoscopic cholecystectomy.During operation, cholecystectomy appeared to be easy . The structure which appeared like cystic duct was actually both - cystic and hepatic ducts adhered strong with fibrous tissue. With the use o window operative laparoscopic technique for preparation of anatomic structures of Calot's triangle, a major biliary injury was prevented. (Abstract truncated at2000 characters).
    Vir: Endoskopska revija : glasilo Sekcije za endoskopsko kirurgijo in Sekcije za gastroenterološko endoskopijo Slovenije = Endoscopic review : journal of Slovenian Society of Endoscopic Surgery and Society of Gastroenterologic Endoscopy. - ISSN 1318-8941 (Letn. 8, št. 20/21, sep./nov. 2003, str. 141-149)
    Vrsta gradiva - članek, sestavni del
    Leto - 2003
    Jezik - slovenski
    COBISS.SI-ID - 17314521

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