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A D V E R T I S E M E N T
A D V E R T I S E M E N T
The gallbladder is manipulated from side to side to expose the serosa for division. Here the cystic duct stump and infundibulum are retracted to the patient's right and the left side of the serosa is scored with cautery 1/2 cm from the liver. A spatula or hook-tipped cautery, or an instrument tip as shown here may be used.
A D V E R T I S E M E N T
Here the infundibulum is pushed to the left and the fundus retracted to the left to expose and cauterize the right side of the gallbladder serosa. There is no set formula for this part of the dissection. Optimal exposure just requires good spatial perception and creative manipulation. Smoke is periodically evacuated from the field as needed. A continuous filtered vent is now available.
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A D V E R T I S E M E N T
Successive manipulation from side to side allows mobilization of the gallbladder from the liver bed. Care is taken beneath the gallbladder to stay out of the liver substance to avoid bleeding and bile leak from the liver. Bile leakage from the gallbladder bed is usually due to injury of a segment V bile duct just deep to the gallbladder rather than to the controversial "ducts of Luschka".
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This page was last modified on 5/19/2000.
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