When Critical View of Safety Fails: A Practical Perspective on Difficult Laparoscopic Cholecystectomy

被引：5

作者：

Alius, Catalin ^{[1
,2
]}

Serban, Dragos ^{[1
,2
]}

Bratu, Dan Georgian ^{[3
,4
]}

Tribus, Laura Carina ^{[5
,6
]}

Vancea, Geta ^{[1
,7
]}

Stoica, Paul Lorin ^{[1
,2
]}

Motofei, Ion ^{[1
,8
]}

Tudor, Corneliu ^{[1
,2
]}

Serboiu, Crenguta ^{[1
]}

Costea, Daniel Ovidiu ^{[9
,10
]}

Serban, Bogdan ^{[1
]}

Dascalu, Ana Maria ^{[1
]}

Tanasescu, Ciprian ^{[3
,4
]}

Geavlete, Bogdan ^{[1
]}

Cristea, Bogdan Mihai ^{[1
]}

机构：

[1] Carol Davila Univ Med & Pharm, Fac Med, Dept Clin Neurosci 6, Div Neurosurg, Bucharest 020021, Romania

[2] Emergency Univ Hosp Bucharest, Gen Surg Dept 4, Bucharest 050098, Romania

[3] Lucian Blaga Univ Sibiu, Fac Med, Preclin Dept, Sibiu 550169, Romania

[4] Sibiu Cty Clin Emergency Hosp, Dept Surg, Sibiu 550245, Romania

[5] Carol Davila Univ Med & Pharm Med, Fac Dent, Bucharest, Romania

[6] Ilfov Emergency Clin Hosp Bucharest, Dept Internal Med, Bucharest 022104, Romania

[7] Clin Hosp Infect & Trop Dis Dr Victor Babes, Clin Infect Dis Dept 3, Bucharest 030303, Romania

[8] Emergency Clin Hosp Sf Pantelimon Bucharest, Dept Gen Surg, Bucharest 021659, Romania

[9] Ovidius Univ Constanta, Fac Med, Constanta 900470, Romania

[10] Emergency Cty Hosp Constanta, Gen Surg Dept, Constanta 900591, Romania

来源：

MEDICINA-LITHUANIA | 2023年 / 59卷 / 08期

关键词：

laparoscopic cholecystectomy; bile duct injury; acute cholecystitis; anatomical landmarks; critical view of safety; bailout surgery; BILE-DUCT INJURY; ACUTE CHOLECYSTITIS; INTRAOPERATIVE CHOLANGIOGRAPHY; SUBTOTAL CHOLECYSTECTOMY; ROUVIERES SULCUS; BILIARY SURGERY; USEFUL LANDMARK; MANAGEMENT; CONVERSION; INCREASES;

D O I：

10.3390/medicina59081491

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The incidence of common bile duct injuries following laparoscopic cholecystectomy (LC) remains three times higher than that following open surgery despite numerous attempts to decrease intraoperative incidents by employing better training, superior surgical instruments, imaging techniques, or strategic concepts. This paper is a narrative review which discusses from a contextual point of view the need to standardise the surgical approach in difficult laparoscopic cholecystectomies, the main strategic operative concepts and techniques, complementary visualisation aids for the delineation of anatomical landmarks, and the importance of cognitive maps and algorithms in performing safer LC. Extensive research was carried out in the PubMed, Web of Science, and Elsevier databases using the terms "difficult cholecystectomy", "bile duct injuries", "safe cholecystectomy", and "laparoscopy in acute cholecystitis". The key content and findings of this research suggest there is high intersocietal variation in approaching and performing LC, in the use of visualisation aids, and in the application of safety concepts. Limited papers offer guidelines based on robust data and a timid recognition of the human factors and ergonomic concepts in improving the outcomes associated with difficult cholecystectomies. This paper highlights the most relevant recommendations for dealing with difficult laparoscopic cholecystectomies.

引用

页数：17

共 91 条

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