EVALUATION OF DIAGONAL LINE (D-LINE) APPROACH DURING ‎LAPAROSCOPIC CHOLECYSTECTOMY: A RANDOMIZED CLINICAL ‎TRIAL

Document Type : Preliminary preprint short reports of original research

Authors

1 Hepatobiliarypancreatic unit, Surgery department, Faculty of medicine, Alexandria university

2 Department of Surgery, Faculty of Medicine, Alexandria University

Abstract

Cholecystectomy is one of the most commonly performed abdominal surgical procedures, and laparoscopic cholecystectomy is considered the “gold standard” for the surgical treatment of gall stone disease because it is associated with less postoperative pain, better cosmesis, and shorter hospital stays than open cholecystectomy. The critical view of safety is a method of ductal identification that has three elements 1) The hepatocystic triangle should be cleared off all fat and fibrous tissue, 2) Two and only two structures (cystic artery and cystic duct) are seen going into the gallbladder in a 360-view, 3) The gallbladder is dissected off the liver bed to expose the lower one-third of the cystic plate. Later, the Tokyo guidelines 2018 (TG-18) advocated the safe steps for achieving the CVS, where the proximal part of the gallbladder is first dissected and the cysti structure is then skeletonized to avoid misidentification . Recently, Kitamura et al. used the right posterior corner of the quadrate lobe of the liver, corresponding to the inferior surface of the segment IV, as an anatomical landmark to start dissection of the gallbladder. The dissection of the gallbladder is securely performed along the diagonal line (D-line) of the quadrate lobe, represented by the imaginary line connecting the left ventral and right posterior corner of the quadrate lobe of the liver.

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ALEXMED ePosters
Volume 6, Issue 1
January 2024
Pages 41-42

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