c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Laparoscopic Cholecystectomy: 25

A D V E R T I S E M E N T

   
 

The curved grasper is used to gently tease the areolar tissue beneath the infundibulum until the cystic artery is identified. Following the path of the anterior branch of the cystic artery on the free surface of the gallbladder can help localize the vessel. Once the vessel is identified, it is freed and isolated by the same maneuvers used for the cystic duct.     

Notes:

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Laparoscopic Cholecystectomy: 26

A D V E R T I S E M E N T

   
 

The cystic artery usually divides near the neck of the gallbladder into the superficial branch and a deep branch. The deep branch runs between the gallbladder wall and the liver bed. Sometimes the two branches are more easily divided separately rather than at their common stem, especially if the bifurcation is proximal, near the common duct.  If only one vessel is found, the other may have a separate origin (see biliary variation) and cause problematic bleeding while mobilizing the gallbladder.    

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Laparoscopic Cholecystectomy: 27

A D V E R T I S E M E N T

   
 

The anatomy of the cystic artery must also be clear before clipping. The key again is staying close to the neck of the gallbladder. The tip of the lower blade must be visible before applying the clip.       

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This page was last modified on 5/19/2000.