title: Blunt Dissection: A Solution to Prevent Bile Duct Injury in Laparoscopic Cholecystectomy.
abstract: BACKGROUND
  Laparoscopic cholecystectomy (LC) has been a standard operation and replaced the open cholecystectomy (OC) rapidly because the technique resulted in less pain, smaller incision, and faster recovery. This study was to evaluate the value of blunt dissection in preventing bile duct injury (BDI) in laparoscopic cholecystectomy (LC).
  
  
  METHODS
  From 2003 to 2015, LC was performed on 21,497 patients, 7470 males and 14,027 females, age 50.3 years (14-84 years). The Calot's triangle was bluntly dissected and each duct in Calot's triangle was identified before transecting the cystic duct.
  
  
  RESULTS
  Two hundred and thirty-nine patients (1.1%) were converted to open procedures. The postoperative hospital stay was 2.1 (0-158) days, and cases (46%) had hospitalization days of 1 day or less, and 92.8% had hospitalization days of 3 days or less; BDI was occurred in 20 cases (0.09%) including 6 cases of common BDI, 2 cases of common hepatic duct injury, 1 case of right hepatic duct injury, 1 case of accessory right hepatic duct, 1 case of aberrant BDI 1 case of biliary stricture, 1 case of biliary duct perforation, 3 cases of hemobilia, and 4 cases of bile leakage.
  
  
  CONCLUSIONS
  Exposing Calot's triangle by blunt dissection in laparoscopic cholecystectomy could prevent intraoperative BDI.
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang 310016, China.
authors.forename: Xiu-Jun
authors.initials: XJ
authors.lastname: Cai
authors.forename: Han-Ning
authors.initials: HN
authors.lastname: Ying
authors.forename: Hong
authors.initials: H
authors.lastname: Yu
authors.forename: Xiao
authors.initials: X
authors.lastname: Liang
authors.forename: Yi-Fan
authors.initials: YF
authors.lastname: Wang
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Jiang
authors.forename: Jian-Bo
authors.initials: JB
authors.lastname: Li
authors.forename: Lin
authors.initials: L
authors.lastname: Ji
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000517:prevention & control*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D003135:Common Bile Duct / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult