Cystic Artery Dissection With Dorsal Infundibular Approach Versus Critical View of Safety

NCT07507292 | Completed

• 1 other identifier: Cystic Artery Dissection
• Study Type: interventional
• Target: 300
• Locations: 1 country
• Sites: 1

Brief Summary

We evaluated the efficacy of combining cystic artery dissection with a dorsal infundibular approach in comparison to the critical view of safety. By analyzing these techniques, we aim to refine laparoscopic cholecystectomy protocols and enhance patient safety by minimizing bile duct complications

Conditions

Laparoscopic Cholecystectomy Surgery

Outcome Measures

Primary Outcomes (1)

• rate of iatrogenic bike duct unjury

  Biliary Tract Injury will be monitored from the start of the surgical procedure through the 30-day postoperative follow-up period. This includes all intraoperative detections and any delayed presentations (leaks or strictures) confirmed via biochemical

Study Arms (2)

critical view of saftey

ACTIVE COMPARATOR

dissection was conducted to provide the critical view of safety prior to the clipping and division of the cystic duct and artery

Procedure: critical view of saftey

cystic artery dissection with dorsal infundibular dissection (CADID)

EXPERIMENTAL

by identification and dissection of the cystic artery along with dorsal infundibular dissection with maintaining the integrity of the hepatocystic triangle

Procedure: cystic artery dissection with dorsal infundibular dissection

Interventions

critical view of saftey PROCEDURE

Achievement of the Critical View of Safety (CVS) requires the completion of three mandatory criteria prior to the application of clips: first, the complete clearance of all fibro-fatty tissue from the hepatocystic triangle; second, the mobilization of the lower pole of the gallbladder from the liver bed to expose at least the inferior third of the cystic plate; and finally, the clear demonstration of exactly two structures-the cystic duct and cystic artery-entering the gallbladder. Only upon definitive visualization of these components is the CVS considered achieved

critical view of saftey

cystic artery dissection with dorsal infundibular dissection PROCEDURE

Following optimized gallbladder retraction and identification of the Rouviere's sulcus, any existing adhesions were cleared via a combination of blunt and sharp dissection. The procedure commenced with a peritoneal incision on the right lateral aspect at the cysto-infundibular junction, facilitating lateral retraction of the infundibulum and opening of the hepatocystic (Calot's) triangle. Subsequently, the left-sided peritoneum was incised along the anterior border of the cystic artery, extending over the inferior fourth of the gallbladder. Precise hemostasis was maintained, particularly at the ductal branches, to ensure a clear operative field. Connecting the bilateral peritoneal incisions ventrally facilitated the creation of a retro-ductal window. This maneuver allowed for superior retraction of the infundibulum away from the common bile duct, effectively straightening the cystic duct for safer identification

cystic artery dissection with dorsal infundibular dissection (CADID)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• the study included adult patients who were candidates for laparoscopic cholecystectomy.

Sponsors & Collaborators

• Zagazig University: lead

Study Sites (1)

Zagazig Univeesity Hospitals

Zagazig, Sharqia Province, Egypt

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: assisstant professor

Study Record Dates

• First Submitted: March 27, 2026
• First Posted: April 2, 2026
• Study Start: December 22, 2022
• Primary Completion: December 22, 2023
• Study Completion: December 22, 2023
• Last Updated: April 2, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)