Antegrade cholecystectomy before ligating the elements. A technique that reduces complications

Area of Science:

• Surgical techniques
• Minimally invasive surgery

Background:

• Retrograde approach is common in open surgery but less frequent in laparoscopic cholecystectomy.
• Antegrade access involves dissecting from the infundibulum to the fundus before clipping the cystic duct.
• This study focuses on experienced laparoscopic surgeons performing antegrade dissection.

Purpose of the Study:

• To analyze the efficacy of antegrade dissection in laparoscopic cholecystectomy.
• To evaluate operative time, complications, and conversion rates using the antegrade approach.

Main Methods:

• A retrospective analysis of 2020 laparoscopic cholecystectomies performed between 2002 and 2017.
• The antegrade technique involved peritoneal incision from infundibulum to fundus along the gallbladder bed.
• Surgeons had extensive experience in laparoscopy.

Main Results:

• No bile duct injuries were reported.
• Average operative time was 38 minutes.
• Conversion to open surgery occurred in 1.5% of cases, primarily in patients with cholecystitis and cirrhosis; mean postoperative stay was 2 days.

Conclusions:

• Antegrade dissection for laparoscopic cholecystectomy appears to be a simpler and faster method.
• This approach has the potential to be a standard procedure, not just for complicated cases.
• Reduced operative time and low complication rates support its wider adoption.