Madany Triangle; a New Era of Laparoscopic Cholecystectomy
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 238
- 试验地点
- 1
- 主要终点
- Is the extrahepatic bile duct still intact or injurie. How many patients with the Common bile ducts will injurie?
研究概览
简要总结
Laparoscopic cholecystectomy has an increased incidence of extrahepatic biliary injury or bleeding. The common hepatic duct is on the medial border of the Calot triangle and at risk of injury. So, The investigators describe a new safety triangle with a more critical view of safety that is far from dangerous.
Retrospectively, from December 2019 until March 2023, the investigators will review the medical records for patients who underwent laparoscopic cholecystectomy.
The patients underwent cholecystectomy using a new technique in approaches to critical safety with recorded video and available follow up data were included.
The patients who had intraoperatively extensive gallbladder adhesion that interfere with the dissection in this area, improper visualization of the cystic duct, patients whose did not operate by this new technique and patients whose have not video record of laparoscopic cholecystectomy will excluded from the study.
详细描述
Operative procedure:
This technique was different from the ordinary laparoscopic cholecystectomy in the following steps: with the aid of electrocautery Hook, the dissection started first with the peritoneum, which covered both sides of the Hartman pouch, the proximal third of the gallbladder (the area of the gallbladder at its neck), and the proximal part of the cystic duct (the end of the cystic duct which was attached to the gallbladder neck).
With using a grasper for manipulating the Hartman pouch for better dissection of the gallbladder bed. Then gently dissecting the gallbladder from its bed to skeletonize it away from the cystic plate and porta hepatis. The small branches of cystic artery that were dipping in the GB wall were cauterized one by one. This step involved scarification of the cystic artery, and its branches, which necessitated the use of bipolar diathermy.
Now, after dissection of the proximal part of the gallbladder from its bed and scarification of the cystic artery and its branches, the traction applied to the Hartman pouch created an angle between the skeletonized cystic duct and the skeletonized posterior surface of the GB.
Also, this traction creates a dynamic triangle visualized from both the left and right sides according to the traction applied to the Hartman pouch to the right or left and the direction of the angled scope of the camera lens.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Crossover
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 8 Years 至 80 Years（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with acute or chronic gall bladder dieses and managed by laparoscopic cholecystectomy.
- •Patients undergo laparoscopic cholecystectomy using Madani triangle approaches.
排除标准
- •The patients who had intraoperatively extensive gallbladder adhesion.
- •Patients managed by open surgical cholecystectomy approaches not laparoscopic.
结局指标
主要结局
Is the extrahepatic bile duct still intact or injurie. How many patients with the Common bile ducts will injurie?
时间窗: December 2019 to March 2023
Is laparoscopic cholecystectomy using Madani triangle technique associated with bile duct injuries or not associated with bile duct injuries or not?
次要结局
未报告次要终点
研究者
Sarah Magdy Abdelmohsen
Lecturer
Aswan University Hospital