How to deal with Intra hepatic Gallbladder?
| Discussion in 'All Categories' started by Dr Avinash Kumar Singh - May 18th, 2016 12:35 am. | |
Dr Avinash Kumar Singh
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Please discuss How to deal with Intra hepatic Gallbladder? |
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re: How to deal with Intra hepatic Gallbladder?
by Dr R K Mishra -
May 18th, 2016
7:58 am
#1
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Dr R K Mishra
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By definition the intrahepatic gallbladder is the one that its entire circumference is surrounded by liver parenchyma and sometime there is some protrusion of the fundus. Intrahepatic gallbladder unfortunately is often dysfunctional and in these patients Cholelithiasis rate reaches more than 60%. In our opinion Laparoscopic cholecystectomy remains the gold standard, it is safe and represents the treatment of choice also in the intra-hepatic gallbladder, making it possible for these patients to get benefit of Minimal Access Surgery. Preoperative MRCP should must be performed in order to rule out other anomalies of the biliary tract and Endo GI linear stapler should be kept if the liver parenchyma need to be resected. CUSA and Liver transection is accomplished with bipolar vessel sealing device and endoscopic stapling device as appropriate. The CUSA system is a powerful ultrasonic aspirator and dissector with a wide application for hepatic resection. |
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re: How to deal with Intra hepatic Gallbladder?
by Dr. Vipul Rai -
May 18th, 2016
8:20 am
#2
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Dr. Vipul Rai
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What CUSA offers sir, over normal Harmonic Scalpel |
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re: How to deal with Intra hepatic Gallbladder?
by Dr. R. K. Mishra -
May 18th, 2016
10:10 am
#3
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Dr. R. K. Mishra
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CUSA full form is Cavitron Ultrasonic Surgical Aspirator (CUSA) which has a capacity to dissect parenchymal tissue without damaging the blood vessels. It is used to perform hepatic resections in patients who need lobectomy or patient with primary or secondary liver tumors. The use of CUSA has proved to be very efficient and safe. In lobectomies and extended lobectomies with minimum bleeding. However once the vessels are identified they should either clipped or stapled. |
