A Case of Laparoscopic Subtotal Cholecystectomy Using a Barbed Suture for Closing the Gallbladder Neck

Abstract

We have performed laparoscopic subtotal cholecystectomy for chronic cholecystitis with Corlette classification type II where a barbed suture (V-Loc^TM Covidien & Co.) was used to close the gallbladder head. After the barbed sutures, the patient had not experienced bile leak nor bile duct obstruction or stricture. In performing laparoscopic subtotal cholecystectomy for acute or chronic cholecystitis, the treatment of the gallbladder neck by sutures using a barbed suture appears to be an available technique according to conditions. It is advantageous that the technique has not a harmful effect caused by making ligation in the body cavity that is inevitable with conventional laparoscopic techniques, however, careful consideration would be necessary for the indication. Because the suture itself demands training and we cannot remake by using a barbed suture so that we have great difficulties in repairing if local injuries or erroneous manipulation against the surrounding bile duct or vascular vessels might occur. In addition, short-term problems might be absent, however, further accumulation of clinical cases and observation would be mandatory in terms of the long-term suitability.