Injrury to the common bile duct in laparoscopic cholecystecomy ranges from .3% to .7%.
The most common reason this occurs is poor visualization of and misidentification of the bile duct structures, because of inflammation or more commonly too vigorous cephalad (toward the head) retraction of the gallbladder.
Excess tension during retraction of the fundus of the gallbladder causes the common bile duct and cystic ducts to align in a parallel fashion and increases the chances of clipping the common bile duct.
One way to avoid this misidentification is to do dissect the tissues in and fully expose the triangle of Calot containing both only cystic duct and artery on the inferior and medial edge of the gallbladder.
Achieving this “critical view” will allow lessen the chances of clipping the common bile duct.
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