الفهرس 
Anatomy of Biliary tree and Gall bladderOnly 14 pages are availabe for public view
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Abstract
aparoscopic cholecystectomy (LC) is the gold standard for the surgical treatment of symptomatic gallstones. The advantages of this surgical approach have included a positive impact on the postoperative quality of the patient’s life as well as optimal short and long term results.
The chief cause for the increased rate of conversion of open surgery has been non visualization of the anatomy at Calot’s triangle due to dense adhesions.
In more than half of the cases, the injury occurs during manoeuvres to isolate the cystic duct or to free GB from CBD. These manoeuvres may be more difficult and consequently more dangerous when there is significant inflammation as may be seen in acute cholecystits or in case of obesity, cirrhosis with portal hypertension, previous surgery with peritoneal adhesions or anatomic variations of the hepatic pedicle. This study has been presented to investigate the place of (FFLC) showing the advantages and disadvantages and comparing it with conventional laparoscopic cholecystectomy (CLC) via many different parameters, especially biliary tract injury.
The aim of this study was to assess the feasibility, safety, and outcome of the fundus first laparoscopic cholecystectomy compared with the conventional laparoscopic cholecystectomy for treatment of calcular cholecystitis.
The study was conducted on Forty (40) consecutive patients with calcular cholecystits admitted at the general surgery department, Ain Shams University hospitals and Theodor Bilharz Research Institute (TBRI) that were managed by laparoscopic cholecystectomy randomly divided into four groups:
(group A1):- (10) patients with acute calcular cholecystitis were managed by fundus first laparoscopic cholecystectomy.
(group A2):- (10) patients with chronic calcular cholecystitis were managed by fundus first laparoscopic cholecystectomy.
(group B1):- (10) patients with acute calcular cholecystitis were managed by conventional laparoscopic cholecystectomy.
(group B2):- (10) patients with chronic calcular cholecystitis were managed by conventional laparoscopic cholecystectomy.
The Data evaluation were based mainly on the comparison between fundus first versus conventional laparoscopic cholecystectomy as regard: time for Identification of triangle of Calot, operative time, incidence of biliary injury, rate of conversion, blood loss, drain flow, post operative complication.
Parameters that were statistically significant included the mean operative time, time for identification of triangle of Calot, conversion to open procedure, while all the other parameters were statistically insignificant.