Evaluation of Feasibility and Safety of the posterior approach of laparoscopic cholecystectomy in patients with symptomatic gallstones

Abstract

Introduction:Laparoscopic Cholecystectomy (LC) which is the gold standard in the treatment of gallbladder diseases.However,this method carries risks of serious complications,including biliary duct injury and bleeding during and after surgery.Although various dissection techniques have been described by different authors to make laparoscopic cholecystectomy safer,there is no consensus on a new,standardised method for dissecting Calot's triangle that is said to prevent biliary injuries (BI).However,all aim to reduce the incidence of such injuries. Aim and Objective:Our study is prospective analysis aiming at assessment of the safety and feasibility of dissection of the triangle of calot from the posterior portion of Cystic duct toward the cystic artery along lateral to the medial Surface few above the sulcus of ROUVIERE with clear identification of parts of critical view of safety which is useful in difficult laparoscopic cholecystectomies. Patient and Methods:Our study was done at the Laparoscopic unit of Minia University Hospital.It was a prospective analysis that was performed on more than 50 patients with symptomatic gall bladder stones. Result:starting the dissection from the posterior aspect of gallbladder Therefore,the probability of injury to any arterial or biliary structure at this level is reduced.It also appears to be a safe decision technique and in patients with vascular and biliary abnormalities. Conclusion:Dissection using posterior approach is one more step towards safer laparoscopic cholecystectomy.Less blood loss and less operative time appear to be the main advantages of using the posterior approach.However,more studies with larger sized samples are needed to substantiate these results.so we recommend that approach for laparoscopic Cholecystectomy