PP 65. Visual Perception of Biliary Tracts With Isosulphan Blue for Prevention of Injury During Laparoscopic Cholecystectomy: A Cadaveric Study

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O. Veli Ozkan, O. Yagmurkaya, M. Feyzi Sahin, A Selcuk Gurler, H. Kucuker, F. Altintoprak, F. Celebi

18:40 - 18:46h at Lanchid Room

Categories: Hepatobiliary and Pancreatic Surgery, Poster Session

Session: Poster (P5) - Hepatobiliary & Pancreatic Surgery

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Background
Bile duct injury as a complication of laparoscopic cholecystectomy may result in biliary cirrhosis with considerable financial burden and increased mortality. It may necessitate several consecutive operations and invasive procedures leading to surgeon anxiety. The most frequent causative factor is the misidentification of the anatomy, especially at the beginning of learning curve. Direct coloration of the cystic duct, ductus choledochus and gall bladder during the surgery may lead to decreased risk of biliary tract injury.

Material and Methods
This study was conducted during the standart autopsies of 10 fresh cadavers at Council of Forensic Medicine in İstanbul. Following the needle puncture of gall bladder fundus and aspiration of the bile content, the same amount of isosulphan blue was injected into the gall bladder in order to colorate the biliary tree. The biliary tract has been visualized coloured by isosulphan blue.

Result
A total of 10 fresh cadavers, 3 males and 7 females with a mean age of 43 ranging between 22 and 76 were studied by isosulphan blue injection technique. They were shown to have no gallstones, sludge and other gall bladder pathologies. Successful visualization of the coloured biliary tract including the gall bladder, cystic duct and ductus choledochus was possible in all of the cadavers.

Conclusion
The visualization of the coloured biliary tract may provide a much safer dissection of Calot triangle. Surgical bile duct injuries related to anatomic misidentification may be eliminated by using intraoperative isosulphan blue injection technique. Investigation with rigorous scientific design is required for widespread clinical use in future.