Résumé
Background: Laparoscopic cholecystectomy is the most commonly performed laparoscopic surgery worldwide. Safe cholecystectomy is the priority to reduce the morbidity and mortality. There is a paradigm shift from extensive Calot’s dissection to identification of Rouviere’s sulcus and lesser dissection. Identification and analysis of Rouviere’s sulcus will help us doing a safe cholecystectomy and avoiding further injuries to bile ducts.Methods: The study included 160 cases of laparoscopic cholecystectomy, posted in elective OT and identified Rouviere’s sulcus during laparoscopy. Table visual inspection and analysis was done. And the collected data was analyzed for different types of sulcus, its position, morphology and content.Results: Of 160 cases, 147 cases had Rouviere’s sulcus. 13 cases did not have a sulcus. Open type sulcus was present in 99 cases, 35 had closed type, whereas 19 had slit type and only 7 had a scar like sulcus. The study showed 92% of our patients had Rouviere’s sulcus and of them 61.9% had an open type which was the most common type of sulcus of them 18 cases had a visible pulsating vessel in the floor of the sulcus i.e. posterior sectional pedicle in the sulcus.Conclusions: Present study showed, in 92% cases it is easy and approachable to visualise the Rouvier’s sulcus. So, it is feasible and beneficial to identify the sulcus and keep the dissection above this level to avoid common bile duct injury and further complication thereof.
Résumé
Background: Cholelithiasis is known to be one of the most common biliary pathologies. Laparoscopic cholecystectomy is the gold standard for the removal of the gallbladder, because of its cosmetic benefit, short stay, cost-effective and lesser side effects. But no procedure is immune to complications and other procedure-related side effects. The present study was conducted to study the patterns of complications and outcome of laparoscopic cholecystectomy.Methods: the present study was conducted prospectively on patients undergoing laparoscopic cholecystectomy for symptomatic gall bladder pathology. the patients undergoing laparoscopic cholecystectomy were distributed and analysed on various parameters i.e. age, sex, ultrasound abdomen findings, complications related to access, per-operative condition of gallbladder, per-operative and postoperative complication.Results: In our study cases major complication rate 1% leading to biliary stricture for which hepaticojejunostomy was done, minor complication rate 11% and conversion to open cholecystectomy rate 2%.Conclusions: It is concluded that laparoscopic cholecystectomy is the safe and standard procedure for the laparoscopic cholecystectomy and its major complication are preventable by strictly following the basic principles of laparoscopic cholecystectomy and keeping a low level of the threshold for converting to open cholecystectomy.