EXPERIENCE IN PREVENTION OF SERIOUS COMPLICATIONS OF LAPAROSCOPIC CHOLECYSTECTOMY

Objective. To study the causes and prevention of the complications of laparoscopic cholecystectomy (LC). Patients and Methods. Based on expe rience with 2 428 cases, the following should be paid attention to whe n dissecting and separating adhesions around the gallbladder and of th e Calot's triangle. The best method for the prevention of mistaking th e common bile duct (CBD) for the cystic duct is to find the junction o f the cystic infundibulum and duct, separate the gallbladder wall alon g the infundibulum, and transect the cystic duct at the junction with the infundibulum. If dense adhesions around the gallbladder or of the Calot's triangle are met with, LC should be abandoned and open cholecy stectomy (OC) should be used instead. In separating the Calot's triang le, blunt dissection should be used to avoid burning the extrahepatic bile duct (EHBD), and blind hemostasis should be avoided. If the cysti c artery lies in the upper part and the back of the cystic duct, the c ystic duct should be dissected out, clipped and cut first, then the cy stic artery be dealt with. If the cystic artery is in the front part o f the pedicle of the gallbladder, the artery should be separated, clip ped and cut first. Injury to the adjacent organs may be avoided by usi ng electric coagulating hook correctly and avoiding accidental damage to the viscera, and keeping from viscera injury due to current chemota xis in the dosed cavity of the body. Results. A total of 2427 patients were cured. One patient died of frequent episodes of supraventricular tachycardia and pneumonia on the 21st day after LC. Conclusion. If LC surgeons follow the abovesaid principles of LC technique, LC is very safe for patients with benign diseases of the gallbladder.