title: An Innovative Emergency Laparoscopic Cholecystectomy Technique; Early Results Towards Complication Free Surgery.
abstract: The performance of laparoscopic cholecystectomy could be a technical challenge. Procedure success depends on multiple factors namely: hepatobiliary anatomical variations, pathologic changes in the gallbladder and surrounding tissues, pre-operative interventional attempts, the individual surgeon's skill and finally patient co-morbidities. Anticipating the attendant challenges, can help to avoid several known complications associated with this procedure. Searching a more reliable anatomical topography to adopt during laparoscopic cholecystectomy is the basis for a safe surgical technique.
  
  
  
  Between January 2012 and August 2015, 525 cases were presented with acute cholecystitis. Patients were classified in to two groups regarding degree of dissection difficulty. The study concept is defined and applied by the author in all study cases. No single case was excluded from the study.
  
  
  
  Results are processed in comparative way between both groups of the study. The increased risk results in Group B are related to technical difficulties.
  
  
  
  The study has offered a novel anatomical concept and safe surgical technique avoiding exploration of Calot's triangle. The new concept has minimized dissection demands and risk of injury related to the traditional laparoscopic cholecystectomy. The study has proposed a potentially secure and empirical laparoscopic cholecystectomy technique that could be considered in every case.
authors: Endoscopic Surgery Unit, Department of General Surgery, King Fahad Hospital, Huffof, Al Ahsa, Kingdom of Saudi Arabia. drmdnasr@gmail.com.
authors: Mohamed Mahmood
authors: MM
authors: Nasr
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041881:Cholecystitis, Acute / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Antegrade dissection; Calot’s triangle; Critical point of surgical control; Critical view of safety; Retrograde dissection