ANATOMO-SURGICAL BASIS FOR OPTIMIZATION OF LAPAROSCOPIC CHOLECYSTECTOMY TECHNIQUE

Aim. To improve the results of laparoscopic cholecystectomies by studying the anatomic variants of hepatoduodenal zone structures, when introducing laparoscope at different angles against the anterior abdominal wall. Materials and methods. Clinical studies included 70 patients with acute and chronic calculous cholecystitis, Variant anatomy of hepatoduodenal zone structures, when laparoscope is introduced at different angles against the anterior abdominal wall, was studied. Results. Typical anatomy of hepatobiliary zone structures was detected in 63 (90 %) patients. Atypical anatomy was noted in 7 (10 %) cases. Awareness of anatomic variants of hepatobiliary zone structures is necessary for the prevention of complications and improvement of therapeutic results. No anatomic peculiarities of hepatoduodenal zone were revealed in the course of US investigation. Conclusions. To make visualization of the organs of the upper store of the abdominal cavity more convenient, it is necessary to introduce laparoscope at the angle of 33-47° against the anterior abdominal wall.

Cholecystectomy, hepatobiliary zone, laparoscopic anatomy, improvement, management