Cbd injury Is a HUMAN Pitfall!
If there is difficulty finding cystic duct 34% cbd injury
- you WILL have cbd injury over time. Can't avoid it but be prepared for it.
Anatomy.
Most dangerous is sliding down of hepatic duct division, cystic duct
Triangle of calot is not necessarily an area of safety
If difficult consider top down dissection
Gayet believes true triangle is right up to the junction of the gallbladder wall and the liver bed.
He has never seen a true duct of lushka. If there truely is a lushka then you should have a hole in the gallbladder wall. Likely a accessory duct in liver bed
Anatomic variations that cause pitfalls.
Short cystic duct
Narrow cbd mimiking cystic
Accessory duct in bed of liver
Tortuous cbd
Sliding bifurcation
- Posted from iPhone
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