Percutaneous Cholecystostomy With Locking Trocar: How I Do It? A Case Report

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Küçük Resim

Tarih

2003

Dergi Başlığı

Dergi ISSN

Cilt Başlığı

Yayıncı

Springer-Verlag

Erişim Hakkı

info:eu-repo/semantics/openAccess

Özet

Cholecystectomy and open cholecystostomy are associated with a high mortality rate in critically ill patients. Ultrasound-guided percutaneous cholecystostomy has a high success rate with few complications. The following method of percutaneous cholecystostomy with locking trocar (LT) under direct laparoscopic vision is seen to be an effective, safe, and practical procedure. After the abdomen is prepared from xiphisternum to symphysis pubis, the umbilicus and surrounding skin are infiltrated with 1% combined lignocaine and adrenaline. A 10-mm laparoscopy trocar is inserted via a 10-mm subumbilical incision. After a camera is inserted via the trocar, the abdomen and gallbladder are exposed. The skin of the geometric projection of fundus is infiltrated with the same solution, and a 5mm LT is introduced via a 5-mm skin incision directed to the fundus of the gallbladder guided by the direct view of a laparoscope. When the LT has penetrated to the gallbladder, the bile and contents of the gallbladder are aspirated immediately to reduce the pressure, and the trocar is locked. The locked trocar is fixed to the abdominal wall under traction until the completion of peritonization to prevent bile leakage. The gallstones can be extracted through the trocar by a laparoscopy forceps. This technique was used for a 75-year-old woman with calculous cholecystitis and cardiopulmonary insufficiency, and her progress at this writing is good.

Açıklama

Anahtar Kelimeler

Percutaneous Cholecystostomy, Locking Trocar, Laparoscopy

Kaynak

Surgical Endoscopy and Other Interventional Techniques

WoS Q Değeri

Q1

Scopus Q Değeri

Cilt

17

Sayı

1

Künye

Vatansev, C., Belviranlı, M., (2003). Percutaneous Cholecystostomy With Locking Trocar: How I Do It? A Case Report. Surgical Endoscopy and Other Interventional Techniques, 17(1), 162-163. Doi: 10.1007/s00464-002-4206-5