2022 Volume 36 Issue 1 Pages 37-46
Laparoscopic cholecystectomy (Lap-C) has become the standard, while serious complications continue to occur with a certain probability. Vascular bile duct injury due to Lap-C is one of the most avoidable complications and its prognosis is poor. It is important to understand the anatomical structures, so called landmarks for avoiding bile duct injury. The establishment of the Critical View of Safety (CVS) is particularly important for avoiding bile duct injury due to misidentification. In addition, in so-called difficult gallbladder, where it is impossible to establish CVS due to fibrotic scarring of the Calot's triangle because of inflammatory changes such as acute cholecystitis, subtotal cholecystectomy is encouraging procedure. Especially, subtotal fenestrating cholecystectomy should be liberally selected. Understanding the landmarks and liberal use of bailout procedures will lead to the completion of safe Lap-C.
