Experience in laparoscopic cholecystectomy by exposing common hepatic duct using blunt dissection to prevent bile duct injury

Abstract

To introduce an effective method for preventing bile duct injury in laparoscopic cholecystectomy. From January 2003 to October 2005, laparoscopic cholecystectomy was performed on 629 patients, 335 males and 294 females, aged 46.3 (14 - 81). The common hepatic duct was exposed by blunt dissection routinely before transecting the cystic duct. No bile duct injury occurred. 7 cases were converted to open procedure, 5 cases for severe abdominal adhesion, one for internal fistula of bile duct to intestinal tract, and another 1 for gall bladder cancer. 2 patients had postoperative complications, one with raw surface bleeding, and the other with incision bleeding. Exposing common hepatic duct by blunt dissection in laparoscopic cholecystectomy can prevent intraoperative bile duct injury. Such procedure is simple, easy to learn and easy to apply.