Laparoskopik Kolesistektomi Sırasında Safra Kesesi Delinmesinin Lastik Bant ile Kapatılması

Band ligation of the perforated gall bladder during laparoscopic cholecystectomy

Hayrullah Derici, Ali Doğan Bozdağ, Tuğrul Tansuğ, Okay Nazlı, Enver Reyhan

Third Surgical Clinic of Atatürk Training and Research Hospital, İzmir Turkey

Surg Laparosc Endosc Percutan Tech. 2007 Dec;17(6):521-3

Abstract:

Perforation of the gall bladder is a frequent complication during laparoscopic cholecystectomy. Grasping the perforated part of the gall bladder, clip application, or endoscopic loop application are possible solutions to prevent spillage. We propose laparoscopic rubber band application to close the perforated part of the gall bladder as an easy and safe method. We performed rubber band application after iatrogenic perforation of the gall bladder during laparoscopic cholecystectomy in 5 patients. Two-millimeter-wide multiple rubber rings, cut from a 14-Fr Foley catheter, are loaded on a grasper. When a perforation occurred during the dissection of the gall bladder, the hole is grasped with this instrument and 1 of the rings is placed on the gall bladder by the aid of a dissector. Thus, the grasper remained available for traction of the Hartmann`s pouch during further dissection of the gall bladder. The rubber bands were placed successfully in all cases. Two perforations occurred in 1 case, and 2 bands were placed with ease. Bile leakage or gall stone spillage did not occur. Operation time was not prolonged. Rubber band ligation of perforation of the gall bladder is a simple, safe, inexpensive, and effective method to prevent spillage of the bile or gallstones in laparoscopic surgery.

(C) 2007 Lippincott Williams & Wilkins, Inc.

Duyurular
Bu sayfalarda Dr. Turhan Tansuğ’un radyoloji arşivindeki çeşitli patolojilere ait konvansiyonel radyolojik görüntülerden örneklere yer verilecektir.
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