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[Dissection of the Calot's triangle by the celioscopic approach]
P Fabiani1, L Iovine, N Katkhouda
1Service de Chirurgie digestive, Hôpital St-Roch, Nice.
Abstract:
Laparoscopy seems to increase the frequency of post-cholecystectomy biliary complications. Irrespective of the instruments and techniques utilized, dissection of Calot's triangle must be performed in compliance with the classical rules of bile duct surgery. These rules are: always keep in contact with the gallbladder; completely dissect the Calot's triangle area which must not contain more than one biliary tract element; never dissect the cystic duct beyond the right border of the hepatic choledochus; never section an element that is not identified with certainty; systematically perform a peroperative transcystic cholangiography, in particular to detect the anatomical variants of the extra-hepatic biliary ducts.