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Tips and tricks to avoid bile duct injury in SILC: an experience of 500 cases

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Abstract

Introduction

Conventional laparoscopic cholecystectomy is the gold standard surgical treatment for symptomatic gallstones. Surgeons have attempted to minimize the number of incisions via single-incision laparoscopic cholecystectomy (SILC), which offers benefits including improved cosmesis, possibly less postoperative pain, and improved patient satisfaction. However, studies show that there is an increased risk of operative complications—in particular bile duct injuries. We report 500 consecutive cases of SILC performed without bile duct injury.

Methods

A retrospective study of 500 continuous cases of SILC performed by the same surgeon at a single institution was conducted. Data on patient demographics, operative details, and postoperative outcomes were collected and evaluated. Detailed analysis of surgical techniques specifically to reduce bile duct injury was performed and described in this study.

Results

In total, 500 patients underwent SILC during the study period. Eight patients needed additional ports to complete the surgery, while one was converted to an open surgery. No serious intraoperative complications, such as bile duct injury, were encountered.

Conclusion

Our experience shows that with due care and caution during SILC, with particular attention towards achieving the critical view of safety and a standardized technique, bile duct injury in SILC can be avoided.

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Authors and Affiliations

  1. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Tony Li

  2. Department of Surgery, National University Hospital, Singapore, Singapore

    Guowei Kim

  3. Division of Hepatobiliary and Pancreatic Surgery and Liver Transplant Program, University Surgical Cluster, National University Hospital, 1E Kent Ridge Road, Singapore, 119228, Singapore

    Stephen Chang

Authors
  1. Tony Li
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  2. Guowei Kim
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  3. Stephen Chang
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Corresponding author

Correspondence to Stephen Chang.

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Disclosure

Covidien provided the SILS™ Port which was used for the first 50 SILS cases. Mr. Li, Dr. Kim, and Dr. Chang have no conflicts of interest or financial ties to disclose.

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Li, T., Kim, G. & Chang, S. Tips and tricks to avoid bile duct injury in SILC: an experience of 500 cases. Surg Endosc 30, 4750–4755 (2016). https://doi.org/10.1007/s00464-016-4802-4

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  • DOI: https://doi.org/10.1007/s00464-016-4802-4

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