Thursday, September 20, 2018

Laparoscopic Cholecystectomy

Laparoscopic Cholecystectomy is safe if the Critical View of Safety (CVS) method of identification of the cystic duct and cystic artery is performed wherever possible. As per SAGES, three criteria are required to achieve the CVS:
1. The hepatocystic triangle is cleared of peritoneum, fat and fibrous tissue. The hepatocystic triangle is defined as the triangle formed by the cystic duct, the common hepatic duct, and inferior edge of the liver. The common bile duct and common hepatic duct do not have to be exposed.
2. The lower one third of the gallbladder is separated from the liver to expose the cystic plate. The cystic plate is also known as liver bed of the gallbladder and lies in the gallbladder fossa.
3. Two and only two structures should be seen entering the gallbladder.

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