Importance of the node of Calot in gallbladder neck dissection: an important landmark in the standardized approach to the laparoscopic cholecystectomy

J Laparoendosc Adv Surg Tech A. 2015 Jan;25(1):28-32. doi: 10.1089/lap.2014.0195. Epub 2015 Jan 5.

Abstract

The current rate of bile duct injury (BDI) after laparoscopic cholecystectomy is 0.4%, which is an unacceptable outcome. Several surgical approaches have been suggested to mitigate the occurrence of this dreaded complication. We propose a standardized approach, using Calot's node as a critical anatomical landmark to guide gallbladder dissection and avoid BDI. We retrospectively analyzed a prospectively gathered database of 907 laparoscopic cholecystectomies using this standardized approach in our practice over a 5-year period. To date we have had no BDI and no cystic duct leak. Therefore, we suggest identification of Calot's node as an additional method to avoid BDI during laparoscopic cholecystectomy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anatomic Landmarks*
  • Bile Duct Diseases / surgery*
  • Child
  • Cholecystectomy, Laparoscopic / standards*
  • Cystic Duct / surgery*
  • Dissection / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intraoperative Complications / prevention & control*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult