Cystic Lymph Node Identification Is More Reliable Than Critical View of Safety in Difficult Cholecystectomies

Background The cystic lymph node (CLN) represents an anatomic safety marker and a surrogate of technique during laparoscopic cholecystectomy (LC). We aim to demonstrate the value CLN in comparison critical view (CVS) study effects increasing difficulty on 2 approaches. Methods A prospective consecutive LC was conducted. Patient demographics, type admission, clinical presentation, operative grade, visualization CLN, identification CVS, time, complications were recorded analyzed. Results Of 393 LCs, half admissions emergencies. Thirty-four percent had obstructive jaundice or acute cholecystitis. visually identified 81.7% with small difference between grades 1 3 versus 4 5. Although CVS unachievable 62 patients, 43 (69.4%) still identifiable CLN. median operating time 68 minutes mortality but no conversions intraoperative complications. Conclusions Identifying could compliment avoiding major ductal injury. Dissecting lateral commence process displaying pedicle structures may be strategy safely achieving CVS. During more difficult where is impossible, key landmark.