CHOLECYSTECTOMY : FUNDUS TO PORTA APPROACH

Area of Science:

• Surgical Procedures
• Gastrointestinal Surgery
• Minimally Invasive Surgery

Background:

• Cholecystectomy is a common surgical procedure for gallbladder removal.
• Controversy exists regarding the optimal dissection strategy: fundus-first versus duct-first.
• The fundus-first method is often used when Calot's triangle anatomy is challenging.

Purpose of the Study:

• To evaluate the safety and efficacy of a planned fundus-first approach in cholecystectomy.
• To compare the fundus-first method with the traditional duct-first approach in terms of anatomical visualization and potential complications.

Main Methods:

• A randomized study involving thirty patients undergoing cholecystectomy.
• Planned fundus-first dissection strategy was implemented for all participants.
• Comparison of outcomes, including operative time, hemorrhage, and anatomical structure identification.

Main Results:

• The fundus-first approach effectively minimized the risk of damage to the common bile duct and right hepatic artery.
• Slightly increased intraoperative hemorrhage was observed compared to the duct-first method.
• Successful visualization and dissection were achieved even in cases with difficult anatomy.

Conclusions:

• A planned fundus-first approach for cholecystectomy is a safe and effective strategy, particularly when anatomical landmarks are obscured.
• This technique offers significant advantages in preventing critical bile duct and vascular injuries during gallbladder surgery.