Ruiz PCA, Cázares MJE, Muñiz CM, García RA

Language: Spanish
References: 17
Page: 84-93
PDF size: 268.83 Kb.

ABSTRACT

For many surgeons, the laparoscopic cholecystectomy is just a basic «routine» surgical procedure. Nevertheless, a wide variety of factors may seriously affect the surgery making it very complex and requiring a great deal of expertise by the surgeon. Some preoperative parameters, clinical and paraclinical, can help us to estimate the difficulty level we’ll be facing during the procedure. Also, there are qualitative and quantitative criteria that should be taken in account when deciding whether or not to convert to an open approach during the laparoscopic cholecystectomy. Difficulties with the pneumoperitoneum establishment, patient’s morphologic variations and comorbidities, biliary anatomical variants, or local and adjacent inflammation, all may increase the surgical risks for the patient. On the same context, some recommendations may be considered to help manipulation, dissection and extraction manouvers, as well as some special considerations for the left-handed surgeon.

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