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Related Experiment Video

Updated: Mar 5, 2026

Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
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Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture

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Laparoscopic antegrade cholecystectomy: a standard procedure?

Nicola Tartaglia1, Pasquale Cianci1, Alessandra Di Lascia1

  • 1Department of Medical and Surgical Sciences, University of Foggia, Luigi Pinto Street, No. 1, 71122 Foggia, Italy.

Open Medicine (Warsaw, Poland)
|March 30, 2017
PubMed
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Antegrade dissection for laparoscopic cholecystectomy (LC) offers a simpler, faster surgical approach. This "fundus first" technique in LC reduces operative time and can be a standard procedure.

Area of Science:

  • Surgical Techniques
  • Minimally Invasive Surgery
  • Gastrointestinal Surgery

Background:

  • The retrograde (
  • fundus first
  • ) approach is common in open surgery but less frequent in laparoscopic cholecystectomy (LC).
  • Laparoscopic cholecystectomy typically uses an antegrade approach, dissecting towards the fundus after accessing the infundibulum.

Purpose of the Study:

  • To analyze the efficacy of an antegrade dissection technique for laparoscopic cholecystectomy.
  • To evaluate the feasibility and outcomes of the antegrade approach in a large series of procedures.

Main Methods:

  • Analysis of 1740 laparoscopic cholecystectomies performed between 2002 and 2015.
  • Implementation of an antegrade dissection technique involving peritoneal incision from infundibulum to fundus and back.
Keywords:
Antegrade dissectionCholecystectomyCholecystitisDifficult cholecystectomyFundus firstLaparoscopy

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  • Experienced surgeons performed all procedures.

    • Main Results:

    • No bile duct injuries were reported.
    • Average operative time was 40 minutes.
    • Conversion to open surgery occurred in 1.3% of cases (acute cholecystitis, cirrhotic patients); mean postoperative stay was 2 days with no sequelae.

    Conclusions:

    • Antegrade gallbladder dissection for LC is an easier technique that reduces surgical time.
    • This approach can be proposed as a standard procedure for LC, not limited to difficult cases.