Preventive measures for bile duct injury and bleeding during laparoscopic cholecystectomy

Objective To investigate the surgical methods for the prevention of bile duct injury and bleeding during laparoscopic cholecystectomy( LC). Methods The clinical data of 600 patients who underwent LC from September 2010 to June 2013 were analyzed retrospectively,and with reference to related articles and data,the methods for the prevention of bile duct injury and bleeding were summarized.Results Among the 600 patients,2 were converted to open surgery and 1 experienced biliary fistula after LC. There were no long- term complications,and all the patients were cured and discharged,without deaths. Conclusion The key points in preventing bile duct injury and bleeding during LC are the attention to blunt dissection and fine anatomy of the Calot's triangle,the emphasis on the separation and identification of the three- dimensional structure of the neck of the gallbladder,a flexible and proper treatment of the anatomic structures of the bile duct in patients with acute or subacute cholecystitis,and a decision on the resection or preservation of the gallbladder wall,which is made according to the situation during surgery.