Madany Triangle; a New Era of Laparoscopic Cholecystectomy

NCT05951374 | Completed

• 1 other identifier: AswanUH6
• Study Type: observational
• Target: 238
• Locations: 1 country
• Sites: 1

Brief Summary

Laparoscopic cholecystectomy has an increased incidence of extrahepatic biliary injury or bleeding. The common hepatic duct is on the medial border of the Calot triangle and at risk of injury. So, The investigators describe a new safety triangle with a more critical view of safety that is far from dangerous. Retrospectively, from December 2019 until March 2023, the investigators will review the medical records for patients who underwent laparoscopic cholecystectomy. The patients underwent cholecystectomy using a new technique in approaches to critical safety with recorded video and available follow up data were included. The patients who had intraoperatively extensive gallbladder adhesion that interfere with the dissection in this area, improper visualization of the cystic duct, patients whose did not operate by this new technique and patients whose have not video record of laparoscopic cholecystectomy will excluded from the study.

Conditions

Laparoscopic Cholecystectomy; Cholecystitis; Gallstone

Keywords

Safe Cholecystectomy,; critical view of safety.

Outcome Measures

Primary Outcomes (1)

• Is the extrahepatic bile duct still intact or injurie. How many patients with the Common bile ducts will injurie?

  Is laparoscopic cholecystectomy using Madani triangle technique associated with bile duct injuries or not associated with bile duct injuries or not?

  December 2019 to March 2023

Interventions

Madany triangle PROCEDURE

After dissection of the proximal part of the gallbladder from its bed and scarification of the cystic artery and its branches, the traction applied to the Hartman pouch created an angle between the skeletonized cystic duct and the skeletonized posterior surface of the GB (Fig. 3). Also, this traction creates a dynamic triangle visualized from both the left and right sides according to the traction applied to the Hartman pouch to the right or left and the direction of the angled scope of the camera lens. From the left-side view, when right traction is applied to the Hartman pouch, it is bound laterally by the skeletonized proximal part of the cystic duct. Superiorly, it is bound by the posterior surface of the proximal part of the skeletonized gallbladder. It was bounded medially by an imaginary line between a point at the junction of the cystic duct with the CBD and a point at the anterior end of the dissected cystic plate (the Madany triangle)

Eligibility Criteria

• Age: 8 Years - 80 Years
• Sex: all
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

all patients male or female , adult or child underwent laparoscopic cholecystectomy using a new visualized technique Madani triangle

You may qualify if:

• Patients with acute or chronic gall bladder dieses and managed by laparoscopic cholecystectomy.
• Patients undergo laparoscopic cholecystectomy using Madani triangle approaches.

You may not qualify if:

• The patients who had intraoperatively extensive gallbladder adhesion.
• Patients managed by open surgical cholecystectomy approaches not laparoscopic.

Sponsors & Collaborators

• Aswan University Hospital: lead

Study Sites (1)

Aswan university

Aswān, Aswan Governorate, 11331, Egypt

Location

MeSH Terms

Conditions

Cholecystitis; Gallstones

Condition Hierarchy (Ancestors)

Gallbladder Diseases; Biliary Tract Diseases; Digestive System Diseases; Cholelithiasis; Cholecystolithiasis; Calculi; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms

Study Officials

• Sarah M Abdelmohsen, Lecturer

  Aswan University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CROSSOVER
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer

Study Record Dates

• First Submitted: June 19, 2023
• First Posted: July 19, 2023
• Study Start: December 1, 2019
• Primary Completion: March 30, 2023
• Study Completion: March 30, 2023
• Last Updated: July 19, 2023

Record last verified: 2023-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: December 2019- March 2023
• Access Criteria: Herein, we describe another triangle with a CVS because the dissection and cauterization of the cystic artery are in the area of the proximal part of the cystic duct (CD) at its junction with the gallbladder (GB) neck, away from the common bile duct (CBD) and right hepatic artery. So, the surgical steps are far from the CT and its medial structure boundary.

Locations

EG (1)