Partial Cholecystectomy

Abstract

Make a Kocher incision two finger breaths below the right costal margin, incising fascia and rectus abdominis and lateral muscles. Maintain hemostasis of abdominal wall vasculature as the peritoneal cavity is entered. One may need to locate and divide the falciform ligament to aid exposure and assist with retraction. A self-retaining retractor should be used to facilitate visualization and allow the surgeon and assistant use of both hands. The authors prefer a Thompson or Omni retractor however a Bookwalter may be used. Any adhesions not already incised should be taken down allowing clearance of the infindubulum as low as safely possible. Gallbladder distension may be relieved with either needle or suction decompression. Bile leakage should be minimized by occluding the opening with a stitch or hemostat.