Pedinculation Method in Laparoscopic Cholecystectomy (Analysis of 475 Consecutive Cases without Biliary Injury)

Abstract

Laparoscopic removal of the gallbladder resulted in a sharp increase in the number of cholecystectomies performed throughout the world. This resulted in a considerable increase in extrahepatic biliary injuries, especially during the learning curve. Among other technical details, meticulous dissection of cystic duct, cystic artery and detachment of 1/3 of gallbladder from the liver before clip application and transection seem to be an important preventive maneuver for extrahepatic biliary injury. This technique is called pedinculation. In this retrospective analysis, 475 consecutive laparoscopic cholecystectomies without extrahepatic biliary injury is presented and routine use of pedinculation is proposed as an important method in prevention of biliary injury.