title: Prevention of Biliary Duct Injury in Laparoscopic Cholecystectomy Using Optical Fiber Illumination in Common Bile Duct.
abstract: BACKGROUND
  Biliary duct injury (BDI) is one of the most common complications in laparoscopic cholectecystomy (LC), in this study, we have tried to place an illuminating optical fiber via endoscopy in the CBD during LC, the biliary duct anatomy can be clearly delineated, thus CBD injury is avoided.
  
  
  METHODS
  Sixteen patients with chronic cholecystitis or/and cholelithiasis from February 2007 to June 2008 were performed LC with placement of optical fiber in CBD, the fiber with cold light illuminates the whole extrahepatic biliary system. Three 6-mm titanium clips were applied to the soft tissue surrounding the hepatic duct, CBD and the cystic duct confluence with CBD, respectively; one titanium clip was applied to the surface of cystic duct near the infundibulum of gallbladder. The cytic duct, CBD and common hepatic duct were clearly identified and delineated in the operating field and LC was performed.
  
  
  RESULTS
  All the 16 patients were performed LC using this procedure successfully, there were no LC-related complications, nor complications related to endoscopic retrograde cholangiopanceatography (ERCP).
  
  
  CONCLUSIONS
  The endoscopically placed optical fiber in the CBD can clearly identify the CBD, Calot's triangle and the common hepatic duct, this can reduce the bile duct injury in LC and imporve the safety of LC.
authors.affiliation: Department of Digestive Diseases, Affiliated Hospital of Hangzhou Normal University (the Second People's Hospital of Hangzhou City), Hangzhou, Zhejiang, China.
authors.forename: Zhi Yong
authors.initials: ZY
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Affiliated Hospital of Hangzhou Normal University (the Second People's Hospital of Hangzhou City), Hangzhou, Zhejiang, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Xu
authors.affiliation: Department of General Surgery, Affiliated Hospital of Hangzhou Normal University (the Second People's Hospital of Hangzhou City), Hangzhou, Zhejiang, China.
authors.forename: Ya Dong
authors.initials: YD
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Affiliated Hospital of Hangzhou Normal University (the Second People's Hospital of Hangzhou City), Hangzhou, Zhejiang, China.
authors.forename: Cheng Gang
authors.initials: CG
authors.lastname: Xu
authors.affiliation: Department of Digestive Diseases, Affiliated Hospital of Hangzhou Normal University (the Second People's Hospital of Hangzhou City), Hangzhou, Zhejiang, China.
authors.forename: Jiang Liang
authors.initials: JL
authors.lastname: Wu
keywords: Biliary duct injury; Cholecystectomy; Cold light; Complication; Laparoscopy; Optical fiber