Mirroring dynamic gallbladder retraction of conventional laparoscopic cholecystectomy at the transumbilical approach.

摘要

BACKGROUND Although single incision laparoscopic cholecystectomy is feasible,1 it is associated with a higher rate of bile duct injury (0.72%) than standard cholecystectomy (0.4-0.5%).2 The main factor responsible seems be suboptimal exposure of Calot's triangle due to lack of independent retraction of the gallbladder fundus and infundibulum, especially for a 'floppy' fundus/large liver overlapping the extra-hepatic biliary tree.3 Various innovative methods are described for gallbladder retraction.2'4'5 However, they lack the ability of dynamic manipulation. We describe a simple technique of fundal retraction.