Your browser doesn't support javascript.
loading
Shoeshine maneuver for cystic duct dissection: a simple technique to make Calot-triangle dissection smooth.
Ribeiro Junior, Marcelo Augusto Fontenelle; Rizzi, Roberto; Khan, Sariya; Makki, Maryam; Mohseni, Shahin.
Afiliación
  • Ribeiro Junior MAF; University of Maryland - School of Medicine - R Adams Cowley Shock Trauma Center -Baltimore (MD) - United States.
  • Rizzi R; Hospital São Luiz - Department of Surgery - São Paulo (SP) - Brazil.
  • Khan S; Batterjee Medical College - Jeddah - Saudi Arabia.
  • Makki M; University of Maryland - School of Medicine - R Adams Cowley Shock Trauma Center -Baltimore (MD) - United States.
  • Mohseni S; Orebro University - School of Medical Sciences - Department of Surgery - Orebro - Sweden.
Acta Cir Bras ; 39: e395224, 2024.
Article en En | MEDLINE | ID: mdl-39109781
ABSTRACT

PURPOSE:

Laparoscopic cholecystectomy, introduced in 1985 by Prof. Dr. Erich Mühe, has become the gold standard for treating chronic symptomatic calculous cholecystopathy and acute cholecystitis, with an estimated 750,000 procedures performed annually in the United States of America. The risk of iatrogenic bile duct injury persists, ranging from 0.2 to 1.3%. Risk factors include male gender, obesity, acute cholecystitis, previous hepatobiliary surgery, and anatomical variations in Calot's triangle. Strategies to mitigate bile duct injury include the Critical View of Safety and fundus-first dissection, along with intraoperative cholangiography and alternative approaches like subtotal cholecystectomy.

METHODS:

This paper introduces the shoeshine technique, a maneuver designed to achieve atraumatic exposure of anatomical structures, local hemostatic control, and ease of infundibulum mobilization. This technique involves the use of a blunt dissection tool and gauze to create traction and enhance visibility in Calot's triangle, particularly beneficial in cases of severe inflammation. Steps include using the critical view of safety and Rouviere's sulcus line for orientation, followed by careful dissection and traction with gauze to maintain stability and reduce the risk of instrument slippage.

RESULTS:

The technique, routinely used by the authors in over 2000 cases, has shown to enhance patient safety and reduce bile duct injury risks.

CONCLUSION:

The shoeshine technique represents a simple and easy way to apply maneuver that can help surgeon during laparoscopic cholecystectomies exposing the hepatocystic area and promote blunt dissection.
Asunto(s)
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colecistectomía Laparoscópica / Conducto Cístico / Disección Límite: Humans Idioma: En Revista: Acta Cir Bras Año: 2024 Tipo del documento: Article Pais de publicación: Brasil
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colecistectomía Laparoscópica / Conducto Cístico / Disección Límite: Humans Idioma: En Revista: Acta Cir Bras Año: 2024 Tipo del documento: Article Pais de publicación: Brasil