Safe use of vascular stapling devices during laparoscopic cholecystectomy in cases with enlarged cystic canal

Abstract

Objectives: Bile duct injuries and fistulas due to bile leakage are observed at certain rates in laparoscopiccholecystectomy. In complicated cases, in patients with cholelithiasis cystic duct edema, the cystic canal maybe enlarged to the extent that it cannot be closed with a clip in a standard operation. In this study we evaluatedthe eficiency of stapler closure of cystic canal.Methods: In this retrospective study the cases who had laparoscopic cholecystectomy and cystic canal wasclosed with stapler between August 2016 and December 2018 were reviewed. Patients' hospital stay andcomplications were noted.Results: Thirty-three patients who were electively operated and cystic canal closure was performed withvascular staples because of a wide cystic canal during the operation were included in this study. Low biledrainage was observed in only one case and this patient had spontaneous regression with conservative followup. Mean duration of hospital stay was 3.7 days. Patients were followed up from 2 months to 28 monthspostoperatively.Conclusions: Endo-vasculer stapler can be used safely during laparoscopic cholecystectomy with a history ofstones in the main bile duct. In this group of patients, it is advisable to make preparations in this directionbefore the operation.