Nobuhiro Ito, PhD. Aoki Memorial Hospital
INTRODUCTION: Laparoscopic cholecystectomy is the gold standard operation for cholecystitis. It is an introductory operation of laparoscopic surgery. We typically use clips to divide the cystic duct. But sometimes it is difficult to clip because of severe inflammation. Cystic duct becomes hard and thick. We may use the linear stapler to divided cystic duct in these cases. Operative cost is to be expensive. On the other hand, to ligate the cystic duct intracorporeally is difficult. In this time, we used the Clinch knot that is one of slipknot techniques. To use this technique become easier to ligate cystic duct tightly.
METHODS AND PROCEDURES: From October, 2014 to August, 2016, we performed 26 cases of clipless laparoscopic cholecystectomy for cholecystitis. Gender ratio was 12 females and 14 males. Mean age was 60.2 year old. All cases used three ports method or single incision. We performed so called dome-down technique. First we dissected gallbladder bed. Cystic artery was divided by ultrasonic cutting device. Finally cystic duct was ligated three times, and divided.
RESULTS: Mean operative time was 104 minutes. Mean blood loss was 7g. The postoperative hospitalization was 6.6 days. There was no complication due to cystic duct ligation. No case had bile leakage from cystic duct. One case was converted to open surgery because of bile duct injury. No other complication was observed.
CONCLUSION: Clipless laparoscopic cholecystectomy is feasible and safe. And this operation is economically. Clinch knot technique is easier to ligate the cystic duct tightly.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80130
Program Number: P091
Presentation Session: Poster (Non CME)
Presentation Type: Poster