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Tips 'n tricks: cholecystectomy: antegrade approach for difficult dissection

L Marx, MD C Hild, MD J Leroy, MD, FRCS J Marescaux, MD, FACS, Hon FRCS, Hon FJSES, Hon FASA, Hon APSA
Epublication WebSurg.com, Oct 2013;13(10). URL: http://websurg.com/doi/vd01en4051

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  • 2013-10-14
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Today, laparoscopic cholecystectomy is a routinely performed surgical intervention. In certain cases, the identification of Calot’s triangle may be difficult due to adhesions or inflammatory infiltrations of adjacent structures. Hydrodissection can allow for an atraumatic dissection but in more complex cases, an antegrade freeing of the gallbladder should be envisaged. Here we present the case of a man benefiting from a difficult laparoscopic cholecystectomy for a pancreatitis with common bile duct stone migration. The flag technique, with an antegrade freeing, must be applied in order to complete the procedure laparoscopically.