العودة إلى الخدماتSAFE LAPAROSCOPIC CHOLECYSTECTOMY

جراحة المرارة

From symptomatic gallstones to acute inflammation, with systematic anatomical identification and safety strategies.

CRITICAL VIEW OF SAFETYICG / NIRBAIL-OUT STRATEGY
استكشف العمليات

ملاحظة: يتوفر التنقل داخل الصفحة بالعربية، بينما يُعرض المحتوى الطبي التفصيلي في هذه الصفحة التخصصية حالياً باللغة الإنجليزية.

ELIXIS · ADVANCED CARE

The goal is not simply removal — it is safe identification

Biliary anatomy is confirmed before division. When inflammation obscures planes, the strategy changes early.

الأعراض

Symptoms that merit assessment

Many gallstones cause no symptoms. Temporary blockage of bile flow may cause biliary colic, while prolonged obstruction can lead to inflammation or other complications.

01

RIGHT UPPER PAIN

Pain in the right upper or central abdomen.

02

AFTER MEALS

Pain often follows a meal and may last from minutes to several hours.

03

TO BACK OR SHOULDER

Discomfort may travel to the back or right shoulder.

04

NAUSEA OR VOMITING

A pain episode may be accompanied by nausea or vomiting.

05

FEVER OR CHILLS

Fever or chills may indicate that inflammation has developed.

06

JAUNDICE

Yellow skin or eyes, dark urine and pale stools may indicate bile-duct obstruction.

Indigestion or bloating alone do not prove gallstone disease. Assessment combines history, examination, blood tests and usually ultrasound.

العمليات

Procedures and safety techniques

These are different clinical scenarios; not every option is used in every patient.

SYMPTOMATIC GALLSTONE DISEASE

Before surgery is recommended, the symptoms are assessed to confirm that gallstones are the likely cause.

متى تُبحث
Biliary colic, gallstone complications or another established indication.
ماذا تتضمن
Ultrasound, blood tests and common-duct assessment guide the appropriate plan.
RIGHT INDICATION

LAPAROSCOPIC CHOLECYSTECTOMY

Removal of the gallbladder through small incisions for symptomatic stones.

متى تُبحث
Symptomatic gallstones or a prior complication with a clear surgical indication.
ماذا تتضمن
Safe dissection, control of the cystic duct and artery, and protected specimen extraction.
SMALL INCISIONS

CRITICAL VIEW OF SAFETY

Three defined anatomical criteria before dividing the cystic duct and artery.

متى تُبحث
A core safety goal in standard laparoscopic cholecystectomy.
ماذا تتضمن
All three criteria are required: the hepatocystic triangle is cleared of fat and fibrous tissue, the lower one third of the gallbladder is separated from the liver to expose the cystic plate, and two —and only two— structures are seen entering the gallbladder.
ANATOMICAL CONFIRMATION

ICG FLUORESCENCE CHOLANGIOGRAPHY

Intravenous ICG displays biliary anatomy with near-infrared imaging and no ionising radiation.

متى تُبحث
Adjunctive mapping in selected laparoscopic procedures.
ماذا تتضمن
The fluorescence view is alternated with white light; it supports but does not replace safe dissection and surgical judgement.
ADJUNCT IMAGING

ACUTE CHOLECYSTITIS SURGERY

Early laparoscopic treatment of an inflamed gallbladder when clinically appropriate.

متى تُبحث
Acute inflammation confirmed by clinical, laboratory and imaging findings.
ماذا تتضمن
Decompression when needed, careful dissection and early use of a safer bail-out strategy or conventional cholangiography when indicated.
TIMELY TREATMENT

SUBTOTAL CHOLECYSTECTOMY

A bail-out strategy when safe anatomical identification is not possible.

متى تُبحث
Severe inflammation, fibrosis or hazardous anatomy in the hepatocystic triangle.
ماذا تتضمن
The safely accessible gallbladder and reachable stones are removed; the remnant and cystic duct are managed according to the anatomy. Bile leak and retained-stone risks remain.
SAFETY FIRST

رسم تشريحي أصلي واقعي للتثقيف — وليس صورة لمريض.

التخطيط والسلامة

Anatomy is confirmed before division

ICG and conventional cholangiography are distinct adjuncts. ICG uses no X-rays and does not reliably exclude common-duct stones; neither tool replaces the Critical View of Safety or surgical judgement.

01

TIME-OUT

A pause before division to confirm anatomy.

02

TWO STRUCTURES

Clear identification of cystic duct and artery.

03

IMAGING

ICG for adjunct anatomical mapping; conventional cholangiography when common-bile-duct imaging is needed.

04

BAIL-OUT

Early change of plan in hazardous anatomy.

الأسئلة

الأسئلة الشائعة

إجابات مختصرة قبل التقييم الجراحي الفردي.

01Is a minimally invasive approach always possible?

No. It is chosen when safe and meaningfully beneficial. Anatomy, previous surgery and complexity may require another approach or conversion.

02How long does recovery take?

Recovery varies with the procedure, disease severity and general health. The individual plan covers mobilisation, diet, work and exercise.

03Is ICG fluoroscopy?

No. It uses near-infrared fluorescence rather than ionising radiation. Contraindications and the possibility of a rare reaction must still be checked.

الأدلة السريرية

الأدلة السريرية

يعتمد الاختيار النهائي على الحالة السريرية والتشريح والإرشادات الحديثة.

هذا المحتوى تثقيفي ولا يغني عن الفحص الطبي. تُناقش الفوائد والمخاطر والبدائل بصورة فردية.

تقييم جراحي فردي

العملية المناسبة تبدأ بالتشخيص والاستطباب المناسبين.

تُراجع الأعراض والفحوص والبدائل أثناء الاستشارة.

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