Laparoscopic management of gangrenous perforated cholecystitis
Epublication WebSurg.com, Mar 2009;09(03). URL: http://websurg.com/doi/vd01en2540
Laparoscopic cholecystectomy is the gold standard for symptomatic cholecystolithiasis. Technical maturation and advances in instrumentation have enabled the application of this procedure for acute cholecystitis. This video demonstrates the surgical approach to performing a laparoscopic cholecystectomy in an older male patient with acute cholecystitis and who has had a previous laparotomy for vascular surgery. The surgeon uses a French approach standing between the patient's legs while he optical trocar is placed supraumbilically, 3cm to the right of the midline in order to avoid the adhesions caused by the previous surgery. An ischemic gallbladder with necrotic area and infundibular perforation was found.