Difficult Gallbladders

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 13 October 2022

⏱️ 37 minutes

🔗️ Recording | iTunes | RSS

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Summary

Gallbladders – bread and butter cases or underestimated challenges? Join Dr. Patrick Georgoff and Dr. Shanaz Hossain as they sit down with Dr. Eric Knauer to discuss difficult gallbladders. In this episode, we discuss the SAGES Safe Cholecystectomy program that were created in an effort to decrease the incidence of bile duct injuries. The six strategies outlined in the program include:
1. Use the Critical View of Safety (CVS) method of identification of the cystic duct and cystic artery during laparoscopic cholecystectomy.

2. Understand the potential for aberrant anatomy in all cases.

3. Make liberal use of cholangiography or other methods to image the biliary tree intraoperatively.

4. Consider an Intra-operative Momentary Pause during laparoscopic cholecystectomy prior to clipping, cutting or transecting any ductal structures.

5. Recognize when the dissection is approaching a zone of significant risk and halt the dissection before entering the zone. Finish the operation by a safe method other than cholecystectomy if conditions around the gallbladder are too dangerous.

a. Subtotal Cholecystectomies – Learn more with this landmark paper: http://dx.doi.org/10.1016/j.jamcollsurg.2015.09.019

6. Get help from another surgeon when the dissection or conditions are difficult.

Take a look at all their great explanations and catch all the important points by completing the online program: https://www.sages.org/safe-cholecystectomy-program/

Dr. Eric Knauer is an assistant professor surgery at Emory University. He has recently published regarding the management of laparoscopic common bile duct stones in General Surgery News and, more importantly, was awarded the junior residents’ teaching award. Check out his great educational videos to learn more:
· Cholecystectomy: https://youtu.be/_oMNRINPY5I
Laparoscopic Common Bile Duct Exploration: https://youtu.be/mXl11I7mya0

Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

If you liked this episode, check out other hepatobiliary episodes here: https://behindtheknife.org/podcast-category/hepatobiliary/

Transcript

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0:00.0	Try to secure across that slice it just wider the post.
0:05.0	How have they done enough?
0:07.0	Can they pull it out the back?
0:09.0	Does the ref have a clue?
0:11.0	When you're shouting at the screen, blow your whistle!
0:16.0	There's no feeling like live TV.
0:19.0	However you watch, a TV licence is your must-have pass to over 400 live TV channels
0:25.0	and it also funds the BBC, such TV licence.
0:30.0	Behind the knife, the Surgery Podcast,
0:39.0	relevant and engaging content designed to help you dominate the day.
0:52.0	Welcome back to another episode of Behind the Knife.
0:55.0	Today we are talking about difficult gallbladders.
0:58.0	From Behind the Knife, we've got Patrick Georgdoff and me, Shenato Sen.
1:02.0	We are also joined by Dr. Eric Nauer.
1:04.0	Dr. Nauer is an assistant professor of surgery at Emory University
1:08.0	and has recently published regarding the management of laparoscopic
1:12.0	common balladx stones and general surgery news.
1:14.0	And more importantly, winner of the junior resident teaching award at Emory.
1:19.0	Welcome Dr. Nauer.
1:21.0	We are so excited to have you join us today.
1:23.0	Thank you guys very much for having me on the podcast.
1:27.0	Laparoscopic colicestectomies are one of the most common surgeries performed by general surgeons.
	...

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