Laparoscopic Surgery for Cholelithiasis

Seigo Kitano and Toshio Bandoh

Department of Surgery 1, Oita Medical University

Laparoscopic cholecystectomy (LC) has been recognized as the standard procedure of choice of cholelithiasis. Because of the limited operative field of vision and the technical diffieculty to manipulate the long forceps, bile duct injury during LC may occur more frequently than open cholecystectomy. For prevention of this complication, good orientation of the bile duct anatomy and to try careful dissection of Calot's triangle are essencial. Since 1993, 268 LCs have been carried out in our institution. Convertion to open surgery due to the peroperative complications was noted in 2 of the patients (0. 7%); a bleeding from the cirrhotic liver bed and a CBD injury. In 34 cases of CBD exploration, we have applied the transcystic bile drainage (C-tube drainage), instead of T-tube drainage. C-tube is used not only for postoperative bile drainage but also for the diagnosis and management of possible remnant stones. With this drainage, hospital stay is greatly shortened and pain is minimum.

Key words
cholelithiasis, laparoscopic cholecystectomy, bile duct injury

Reprint requests
Seigo Kitano Department of Surgery 1, Oita Medical University 1-1 Idaigaoka, Hasama-machi, Oita, 879-5593 JAPAN

Accepted
May 25, 1999

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