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Exit strategies for the difficult gallbladder: When and how to convert to open cholecystectomy

 

Presented by Michael J Pucci at the Your Session: Prevention of Bile Duct Injury held during the 2017 SAGES Annual Meeting in Houston, TX on Wednesday, March 22, 2017


Keyword(s): advanced biliary procedure, age, antibiotics, argon beam coagulator, bail out, BDI, bile duct injury, bile leak, biliary injury, biliary tree, bilous, CCX, chronic cholecystitis, cirrhotic, convert, critical view of safety, CVS, cystic duct, cystic plate, difficult gallbladder, drain, ductal identification, endocatch, epigastrum, exit strategies, experience, fulgurate, fundus, gallbladder, gallbladder cancer, gangrene, gangrenous gallbladder, hepatoduodenal ligament, hidden gallbladder, impacted stone, inflammation, inflammatory mass, infundibulum, lack of progress, laparoscopic, laparoscopic cholecystectomy, laparoscopic needle drivers, laparoscopists, laparoscopy, ligate, longitudinal, male, meta-analysis, midline laparotomy, minimally invasive surgeons, Mirizzi syndrome, misidentification, necrosis, necrotic, open cholecystectomy, open subtotal cholecystectomy, operative, optics, percutaneous cholecystostomy, perioperative complications, portal pedicle, ports, prevention, purulent, retraction, risk factors, Rouvieres sulcus, safety, self-retainer, stomach, subcostal incision, subtotal fenestrating cholecystectomy, suction irrigator, suture ligate, suturing, systematic review, total cholecystectomy, tranhepatic biliary drainage catheters, transverse, ultrasonic shears, vasculobiliary injuries

Simple method to handle the dificult GB–1:32 J Laparoendosc Adv Surg Tech A 2017

Bail out–2:58

Importance of a definitive method–3:54

Fixing the problem & keeping the pt safe–4:20

When to stop–5:27

Evidence of trouble ahead (obvious)–6:12

Video clip–6:50

Evidence of trouble ahead (more subtle)–7:21

Video clip–8:13

When you’ve decided to stop–9:01

Lap vs open chole–9:30 JAMA Surg 2015

When to convert–10:55

Fenestrating subtotal CCX–11:47

The “how-to”–12:09

Complicated gallbladder equipment–12:23

Video clip–13:01

Tips for success–14:01

Conversion–14:43

Open CCX–15:20

Beware! Beware! Beware!–15:47 HPB 2012

JACS 2008

Total open CCX approaches–16:43

Open subtotal cholecystectomy–17:45

Summary–18:19

1,419

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Related

Video Uploaded By:
SAGES Webmaster
Uploaded on
03/22/2017
Learning Themes
HPB / Biliary
Sources
2017 Annual Meeting
Masters Level
300
Video Authors
Pucci M
Video Institutions
Sidney Kimmel Medical College at Thomas Jefferson University--Philadelphia PA

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