Overlapped-clipping, a new technique for ligation of a wide cystic duct in laparoscopic cholecystectomy

Abstract

A wide or enlarged cystic duct is a common encounter in laparoscopic cholecystectomy. Many techniques are used to secure its ligation; including internal or extracorporeal knots and Roeder knot. A preformed knot can be used e.g. ETHIBINDER; the Endoloop. The Endo GIA is a useful stapling device but is more expensive. Other simpler techniques have also been described. The author developed a new, simple, safe and quick technique to ligate the wide cystic duct utilizing the commonly used multiple clip appliers. The technique does not need special skill or instruments and ensures complete ligation of the wide cystic duct using overlapping of the clips.