Anatomical techniques and references for a safe laparoscopic cholecystectomy: a literature review
DOI:
https://doi.org/10.33448/rsd-v11i10.32811Keywords:
Laparoscopic cholecystectomy; Cholecystectomy; Surgical laparoscopy.Abstract
The present study aimed to discuss the safe techniques for a laparoscopic cholecystectomy. Integrative literature review with data collection in the following databases: PubMed, UpToDate and Scielo. The descriptors were used: “Safe laparoscopic cholecystectomy”, “Anatomical references for videocholecystectomy”, “Laparoscopic cholecystectomy”. Totaling in a selection of 39 articles discussed. Currently, the laparoscopic approach is the gold standard for cholecystectomy, being considered a basic laparoscopic procedure, because the gallbladder is fixed to the liver and with this, the surgeon works in a single quadrant, avoiding large displacements in the abdominal cavity. However, for the technique to be developed in a safe way for both the surgeon and the patient, a rich anatomical knowledge is essential. Initially, a detailed abdominal inspection is necessary, aiming at the correct choice of the site of entry of the trochanters. After that, the surgeon should opt for the Critical View technique. After that, it is necessary to know some fixed anatomical landmarks to find the safe zone of dissection delineating the cystic duct and the cystic artery. Finally, it is important that a time limit is established for each step. Such a procedure, if followed correctly, is considered very safe, however, the risk of bile duct injury remains a significant concern, particularly in difficult laparoscopic cholecystectomy or with aberrant anatomy. Thus, the causes of biliary injuries are classified into two types: problems of incorrect identification of the anatomy and problems of technique.
References
Adamsen, S., Hansen, O. H., Funch-Jensen, P., Schulze, S., Stage, J. G., & Wara, P. (1997). Bile duct injury during laparoscopic cholecystectomy: a prospective nationwide series. Journal of the American College of Surgeons, 184(6), 571–578.
Adkins, R. B., Jr, Chapman, W. C., & Reddy, V. S. (2000). Embryology, anatomy, and surgical applications of the extrahepatic biliary system. The Surgical clinics of North America, 80(1), 363–379. https://doi.org/10.1016/s0039-6109(05)70410-2
Ahmad, G., Baker, J., Finnerty, J., Phillips, K., & Watson, A. (2019). Laparoscopic entry techniques. The Cochrane database of systematic reviews, 1(1), CD006583. https://doi.org/10.1002/14651858.CD006583.pub5
Berci, G., Hunter, J., Morgenstern, L., Arregui, M., Brunt, M., Carroll, B., Edye, M., Fermelia, D., Ferzli, G., Greene, F., Petelin, J., Phillips, E., Ponsky, J., Sax, H., Schwaitzberg, S., Soper, N., Swanstrom, L., & Traverso, W. (2013). Laparoscopic cholecystectomy: first, do no harm; second, take care of bile duct stones. Surgical endoscopy, 27(4), 1051–1054. https://doi.org/10.1007/s00464-012-2767-5
Berry, S. M., Ose, K. J., Bell, R. H., & Fink, A. S. (1994). Thermal injury of the posterior duodenum during laparoscopic cholecystectomy. Surgical endoscopy, 8(3), 197–200. https://doi.org/10.1007/BF00591829
Blumgart, L. H. (1988). Surgery of the liver and biliary tract. Churchill Livingstone, Edinburgh.
Bresadola, V., Pravisani, R., Pighin, M., Seriau, L., Cherchi, V., Giuseppe, S., et al (2016). Clinical strategies to aim an adequate safety profile for patients and effective training for surgical residents: The laparoscopic cholecystectomy model. Ann Med Surg (Lond);11:58-61. Published 2016 Sep 28. 10.1016/j.amsu.2016.09.006 » https://doi.org/10.1016/j.amsu.2016.09.006
Brooks, D. C., Becker, J. M., Connors, P. J., & Carr-Locke, D. L. (1993). Management of bile leaks following laparoscopic cholecystectomy. Surgical endoscopy, 7(4), 292–295. https://doi.org/10.1007/BF00725942
Brunt, M. (2018). Strategies for minimizing bile duct injuries: Adopting a universal culture of safety in cholecystectomy. SAGES. https://www.sages.org/safe-cholecystecto
Caratozzolo, E., Massani, M., Recordare, A., Bonariol, L., Antoniutti, M., Jelmoni, A. & Bassi, N. (2004) Utilidade da colangiografia operatória e conversão para diminuir as principais lesões do ducto biliar durante a colecistectomia laparoscópica. Journal of Hepato-Biliary-Pancreatic Surgery, 10.1007/s00534-003-0884-1, 11, 3, (171-175),
Celarier, S., Monziols, S., Célérier, B., Assenat, V., Carles, P., Napolitano, G., Laclau-Lacrouts, M., Rullier, E., Ouattara, A., & Denost, Q. (2021). Low-pressure versus standard pressure laparoscopic colorectal surgery (PAROS trial): a phase III randomized controlled trial. The British journal of surgery, 108(8), 998–1005. https://doi.org/10.1093/bjs/znab069
Chen, W. J., Ying, D. J., Liu, Z. J., & He, Z. P. (1999) Analysis of the arterial supply of the extrahepatic bile ducts and its clinical significance. Clin Anat 12: 245– 249.
Csikesz, N. G., et al (2010). “Surgeon volume metrics in laparoscopic cholecystectomy.” Digestive diseases and sciences vol. 55,8: 2398-405.10.1007/s10620-009-1035-6
Davidoff, A. M., Pappas, T. N., Murray, E. A., Hilleren, D. J., Johnson, R. D., Baker, M. E., Newman, G. E., Cotton, P. B., & Meyers, W. C. (1992). Mechanisms of major biliary injury during laparoscopic cholecystectomy. Annals of surgery, 215(3), 196–202. https://doi.org/10.1097/00000658-199203000-00002
Eikermann, M., Siegel, R., Broeders, I., Dziri, C., Fingerhut, A., Gutt, C., Jaschinski, T., Nassar, A., Paganini, A. M., Pieper, D., Targarona, E., Schrewe, M., Shamiyeh, A., Strik, M., Neugebauer, E. A., & European Association for Endoscopic Surgery (2012). Prevention and treatment of bile duct injuries during laparoscopic cholecystectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). Surgical endoscopy, 26(11), 3003–3039. https://doi.org/10.1007/s00464-012-2511-1
Ejaz, A., Spolverato, G., Kim, Y., Dodson, R., Sicklick, J. K., Pitt, H. A., Lillemoe, K. D., Cameron, J. L., & Pawlik, T. M. (2014). Long-term health-related quality of life after iatrogenic bile duct injury repair. Journal of the American College of Surgeons, 219(5), 923–32. e10. https://doi.org/10.1016/j.jamcollsurg.2014.04.024
Fletcher, D. R., Hobbs, M. S., Tan, P., Valinsky, L. J., Hockey, R. L., Pikora, T. J., Knuiman, M. W., Sheiner, H. J., & Edis, A. (1999). Complications of cholecystectomy: risks of the laparoscopic approach and protective effects of operative cholangiography: a population-based study. Annals of surgery, 229(4), 449–457. https://doi.org/10.1097/00000658-199904000-00001
Gadzijev, E. M. (2002). Surgical anatomy of hepatoduodenal ligament and hepatic hilus. Journal of hepato-biliary-pancreatic surgery, 9(5), 531–533. https://doi.org/10.1007/s005340200068
Gomez, D., et al (2022). Colecistectomía total en colecistitis complicada: ¿es una conducta segura. rev. colomb. cir. Bogotá , 34(1), 29-36, Mar. 2019. <http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S201175822019000100029&lng=en&nrm=iso>. https://doi.org/10.30944/20117582.95.
Gupta, V., & Jain, G. (2019). Safe laparoscopic cholecystectomy: Adoption of universal culture of safety in cholecystectomy. World journal of gastrointestinal surgery, 11(2), 62–84. https://doi.org/10.4240/wjgs.v11.i2.62
Hawasli A. (1993). Does routine cystic duct cholangiogram during laparoscopic cholecystectomy prevent common bile duct injury?. Surgical laparoscopy & endoscopy, 3(4), 290–295.
Hibi T., et al. (2017) The “right” way is not always popular: comparison of surgeons’ perceptions during laparoscopic cholecystectomy for acute cholecystitis among experts from Japan, Korea and Taiwan. Hepatobiliary Pancreat Sci. Jan;24(1):24-32.
Hugh, T. B., Kelly, M. D., & Mekisic, A. (1997). Rouvière's sulcus: a useful landmark in laparoscopic cholecystectomy. The British journal of surgery, 84(9), 1253–1254. https://doi.org/10.1046/j.1365-2168.1997.02769.x
Hunter J. G. (1991). Avoidance of bile duct injury during laparoscopic cholecystectomy. American journal of surgery, 162(1), 71–76. https://doi.org/10.1016/0002-9610(91)90207-t
Kum, C. K., Eypasch, E., Lefering, R., Paul, A., Neugebauer, E., & Troidl, H. (1996). Laparoscopic cholecystectomy for acute cholecystitis: is it really safe?. World journal of surgery, 20(1), 43–49. https://doi.org/10.1007/s002689900008
Kurosaki, I., Tsukada, K., Hatakeyama, K., & Muto, T. (1996). The mode of lymphatic spread in carcinoma of the bile duct. Am J Surg 172: 239– 243.
Koche, J. C. (2011). Fundamentos de metodologia científica. Petrópolis: Vozes. http://www.brunovivas.com/wp-content/uploads/sites/10/2018/07/K%C3%B6che-Jos%C3%A9-Carlos0D0AFundamentos-de-metodologia-cient%C3%ADfica-_-teoria-da0D0Aci%C3%AAncia-e-inicia%C3%A7%C3%A3o-%C3%A0-pesquisa.pdf
Pal, K. M., Ali, A., & Bari, H. (2018) Role of percutaneous cholecystostomy tube placement in the management of acute calculus cholecystitis in high risk patients. J Coll Physicians Surg Pak.;28:386-9.
Park, Y. H., & Oskanian, Z. (1992). Obstructive jaundice after laparoscopic cholecystectomy with electrocautery. The American surgeon, 58(5), 321–323.
Pereira, A. S., et al. (2018). Metodologia da pesquisa cientifica. [free e-book]. Santa Maria: UAB/NTE/UFSM. https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1.
Rath, A. M., Zhang, J., Bourdlat, D., & Chevrel, J.P. (1993) Arterial vascularisation of the extrahepatic biliary tract. Surg Radiol Anat 15: 105– 111.
Russell, J. C., Walsh, S. J., Mattie, A. S., & Lynch, J. T. (1996). Bile duct injuries, 1989-1993. A statewide experience. Connecticut Laparoscopic Cholecystectomy Registry. Archives of surgery (Chicago, Ill. : 1960), 131(4), 382–388. https://doi.org/10.1001/archsurg.1996.01430160040
Schol, F. P., Go, P. M., & Gouma, D. J. (1994). Risk factors for bile duct injury in laparoscopic cholecystectomy: analysis of 49 cases. The British journal of surgery, 81(12), 1786–1788. https://doi.org/10.1002/bjs.1800811225
Soper, N. & Malladi, P. (2020). Laparoscopic Cholescystectomy. UpToDate.
Sousa, J. H. B., et al. (2021) Laparoscopic cholecystectomy performed by general surgery residents. Is it safe? How much does it cost. Revista do Colégio Brasileiro de Cirurgiões [online]. v. 48 e20202907. <https://doi.org/10.1590/0100-6991e-20202907>. Epub 17 Maio 2021. ISSN 1809-4546. https://doi.org/10.1590/0100-6991e-20202907.
Strasberg, S. M. (2005). Biliary injury in laparoscopic surgery: part 2. Changing the culture of cholecystectomy. Journal of the American College of Surgeons, 201(4), 604–611. https://doi.org/10.1016/j.jamcollsurg.2005.04.032
Strasberg, S. M., Hertl, M., & Soper, N. J. (1995). An analysis of the problem of biliary injury during laparoscopic cholecystectomy. Journal of the American College of Surgeons, 180(1), 101–125.
Sutherland, F., & Bola, C. G. (2015). A heurística e a psicologia das lesões do ducto biliar. Em: Dixon, E., Vollmer, C. M. Jr., May, G. R., et al., editores. Tratamento de estenose biliar benigna e lesão.Suíça: Springer; pp. 191-198.
Wiechel, K. L. (1996). Biliary anatomy — imaging and surgery: problems, possibilities, pitfalls and risks. Endoscopic Rev 1: 3– 20.
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