title: [Color Doppler ultrasonographic assessment of the risk of injury to major branch of the middle hepatic vein during laparoscopic cholecystectomy].
abstract: OBJECTIVE
  To investigate the cause of hemorrhage from the gallbladder bed during laparoscopic cholecystectomy.
  
  
  METHODS
  Color Doppler ultrasound was used to examine the cause of venous hemorrhage from the gallbladder bed during laparoscopic cholecystectomy in 1 patient postoperatively and to examine the anatomic relationship between the gallbladder bed and branches of the middle hepatic vein in 91 patients preoperatively.
  
  
  RESULTS
  There is a major branch of middle hepatic vein extended close to the gallbladder bed. The branch of the middle hepatic vein was completely adherent to the gallbladder bed in 14 of 91 patients (15.4%). The mean distance between the closest point of the middle hepatic vein and the gallbladder bed is 5.0 +/- 4.6 mm, the mean diameter of this point is 3.2 +/- 1.1 mm.
  
  
  CONCLUSIONS
  Patients with large branches of the middle hepatic vein close to the gallbladder bed are at risk of hemorrhage during laparoscopic cholecystectomy and should be identified preoperatively with ultrasound.
authors.affiliation: Department of Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China.
authors.forename: Baiyong
authors.initials: B
authors.lastname: Shen
authors.forename: Hongwei
authors.initials: H
authors.lastname: Li
authors.forename: Man
authors.initials: M
authors.lastname: Chen
authors.forename: Minhua
authors.initials: M
authors.lastname: Zheng
authors.forename: Lu
authors.initials: L
authors.lastname: Zang
authors.forename: Shaomin
authors.initials: S
authors.lastname: Jiang
authors.forename: Jianwen
authors.initials: J
authors.lastname: Li
authors.forename: Yu
authors.initials: Y
authors.lastname: Jiang
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color