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Closure of the Cystic Duct During Laparoscopic Cholecystectomy in Children Using the LigaSure Vessel Sealing System

World Journal of Surgery volume 35, pages 212–216 (2011)Cite this article

Abstract

Background

The goal of the present study was to evaluate the efficacy of the LigaSure™ Vessel Sealing System (LVSS) when used for cystic duct closure during laparoscopic cholecystectomy in children and adolescents.

Methods

The laparoscopic cholecystectomy was performed beginning with visualization of Calot’s triangle, and dissection of Calot’s triangle was achieved using a monopolar cautery device. Once the cystic duct was exposed, sealing was performed proximally and distally, and the cystic duct was divided midway using the LVSS. The procedure was completed in the standard fashion.

Results

The closure of the cystic duct was performed in seven cases of simultaneous cholecystectomy and splenectomy and in 15 cases of microlaparoscopic cholecystectomy. The patients’ ages ranged from 7 to 21 years (average = 14.5 years), and body weight ranged from 42 to 83 kg (average = 58 kg). There was no bile leakage noted, and the closure of the cystic duct was sufficient in all cases. We noted one case of common bile duct obstruction on postoperative day 1. In this case, an exploration of the biliary tree was performed by laparotomy. No direct injury to the common bile duct was found during exploration, but thermal changes were detected in the surrounding tissues as a result of transmitted thermal energy caused by bipolar cautery device.

Conclusion

The closure of the cystic duct using the LVSS is feasible and effective in laparoscopic cholecystectomy in children. However, it is important to keep a safe distance from other intra-abdominal structures when using thermal energy devices to prevent thermal collateral damage.

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Affiliations

  1. Department of Pediatric Surgery, University Medical Center, Johannes Gutenberg University, 55099, Mainz, Germany

    Salmai Turial, Veronika Engel, Tamer Sultan & Felix Schier

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  1. Salmai Turial
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  2. Veronika Engel
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  3. Tamer Sultan
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  4. Felix Schier
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Correspondence to Salmai Turial.

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Turial, S., Engel, V., Sultan, T. et al. Closure of the Cystic Duct During Laparoscopic Cholecystectomy in Children Using the LigaSure Vessel Sealing System. World J Surg 35, 212–216 (2011). https://doi.org/10.1007/s00268-010-0813-9

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  • DOI: https://doi.org/10.1007/s00268-010-0813-9

Keywords

  • Common Bile Duct
  • Laparoscopic Cholecystectomy
  • Cystic Duct
  • Harmonic Scalpel
  • Biliary Leakage