An evidence based guide to a safe intraoperative approach of avoiding iatrogenic lesions during difficult laparoscopic cholecystectomies

Abstract

An evidence based guide to a safe intraoperative approach of avoiding iatrogenic lesions during difficult laparoscopic cholecystectomies Cover Page FootnoteThis scientific material is part of a lager retrospective study of a PhD thesis, currently under development by Moldovan Cosmin, M.D., Ph. D. student at the Carol Davila University of Medicine and Pharmacy, Bucharest, with Prof. Vladimir Beliș. M.D., PhD., as thesis coordinator. The thesis has the following title: "Contributions to the forensic and legal study regarding the consequences of the iatrogenic lesions of the main biliary pathways occurred during the laparoscopic approach of hepato-biliary surgery". All authors have read and approved the final manuscript and also declare no conflicts of interest. Abstract Introduction: Although there are many sources for iatrogenic lesions during laparoscopic cholecystectomy, only a few stand out as being one of the most difficult to predict due to their nature of being very hard to diagnose before surgery.Materials and Methods: a short guide of cases with an evidence-based approach to avoid laparoscopic iatrogenic lesions. Results: these cases have been classified and presented into 3 main groups: cases with abnormal arterial layout, cases with heavy alteration of the normal anatomy, and cases with anomalies of the main biliary pathway. Conclusions: while not a complete guide covering all aspects of intraoperative traps during laparoscopic cholecystectomy, this series of cases points out some dangerous situations and some simple solutions to avoid those fiercely iatrogenic lesions of the ductal and vascular landmarks associated with an otherwise simple surgical intervention that has become the golden standard of the gallbladder lithiasic pathology. Moldovan CA. et al. 50