Fundus First Method with Catgut Loop for Ligation of Cystic Artery and Duct Stump: An Alternative Technique to Conversion in Difficult Laparoscopic Cholecystectomy
Journal Title: New Indian Journal of Surgery - Year 2017, Vol 8, Issue 4
Abstract
Background: Laparoscopic cholecystectomy is now accepted worldwide as the gold standard surgical technique for cholecystitis. But it is not without difficulties especially in a/c cases.Here we discuss about our experience in difficult cholecystectomy which we managed with fundus first method especially when it is difficult to dissect out cystic artery and duct at calot’s triangle due to dense adhesions. After dissecting fundus, body and neck catgut loops were used to tie the cystic pedicle. Methods: 100 cases of laparoscopic cholecystectomy done in patients presented with abdominal pain and USG diagnosis of cholecystitis. The cases were analysed prospectively with data sheets and video recordings over a period of 18 months. The period of study and the 100 cases were selected for statistical significance. Among those 28 cases were done with fundus first technique and out of these 22 cases were with catgut loop tie technique. Results: Conversion rate was 0% and there was no CBD injury. On follow up two cases had problems one with retained stones in CBD and other in the cystic duct. One case was managed with endoscopic sphincterotomy and the other case with laparoscopy. Conclusion: Fundus first method with catgut loop tie of cystic pedicle with frozen calot’s and thickened cystic duct stump is an alternative technique for conversion to open surgery in difficult cholecystectomy. It is a safe technique with decreased post–operative morbidity.
Authors and Affiliations
Dinesh Babu M. V.
Keywords
Related Articles
- EP ID EP473534
- DOI 10.21088/nijs.0976.4747.8417.21
- Views 115
- Downloads 0
A Clinical Profile of Acute Intestinal Obstruction Cases at Tertiary Care Hospital
Introduction: Mortality and morbidity are dependent on early recognition and correct diagnosis of obstruction. If untreated, strangulated obstruction causes death in 100% of patients. If surgery is performed within 36 ho...
Correlation between Human Epidermal Growth Factor Receptor and Hormonal Receptor Status with Grade and Nodal Status in Carcinoma Breast: A Prospective Observational Study
Breast carcinoma is the most common malignant tumor and the leading cause of carcinoma death in women. Tissue evaluation gives information about various receptors which are yield prognostic information for further treatm...
A Retrospective Study of Preoperative Predictive Factors of Strangulation in Intestinal Obstruction
methodology to prevent nontherapeutic laparotomy while minimizing the chance of overlooking strangulation obstruction causing intestinal ischemia. Our aim was to identify preoperative risk factors associated with strangu...
The Pattern of Anatomical Location of the Parathyroid Glands: A Prospective Study
Introduction: The origin of parathyroid glands is from branchial pouches. As the fetus grows the parathyroid drift to their location near to the thyroid gland, but the final destination of the parathyroid glands are very...
Clinico-Pathological Study and Management Stategies of Liver Abscess: a Prospective Study in Narayana General Hospital
Context: Liver abscess continues to be disease with considerable mortality in our country. Amoebic liver abscess, pyogenic and tubercular aetiologies should always be entertained in the differentials. The incidence of tu...