title: Band ligation of the perforated gall bladder during laparoscopic cholecystectomy.
abstract: Perforation of the gall bladder is a frequent complication during laparoscopic cholecystectomy. Grasping the perforated part of the gall bladder, clip application, or endoscopic loop application are possible solutions to prevent spillage. We propose laparoscopic rubber band application to close the perforated part of the gall bladder as an easy and safe method. We performed rubber band application after iatrogenic perforation of the gall bladder during laparoscopic cholecystectomy in 5 patients. Two-millimeter-wide multiple rubber rings, cut from a 14-Fr Foley catheter, are loaded on a grasper. When a perforation occurred during the dissection of the gall bladder, the hole is grasped with this instrument and 1 of the rings is placed on the gall bladder by the aid of a dissector. Thus, the grasper remained available for traction of the Hartmann's pouch during further dissection of the gall bladder. The rubber bands were placed successfully in all cases. Two perforations occurred in 1 case, and 2 bands were placed with ease. Bile leakage or gall stone spillage did not occur. Operation time was not prolonged. Rubber band ligation of perforation of the gall bladder is a simple, safe, inexpensive, and effective method to prevent spillage of the bile or gallstones in laparoscopic surgery.
authors: Izmir Atatürk Training and Research Hospital, Third Surgical Clinic, Turkey.
authors: Hayrullah
authors: H
authors: Derici
authors: Ali Doğan
authors: AD
authors: Bozdağ
authors: Tugrul
authors: T
authors: Tansug
authors: Okay
authors: O
authors: Nazli
authors: Enver
authors: E
authors: Reyhan
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D005704:Gallbladder / Q000293:injuries* / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery*; D008026:Ligation / Q000379:methods*; D016896:Treatment Outcome