# Exploring the Advantages and Techniques of Intraoperative Transcholecystic Methylene Blue Injection in Laparoscopic Cholecystectomy

## TL;DR

This paper explores using methylene blue injection during laparoscopic cholecystectomy to improve surgical safety and avoid bile duct injuries.

## Contribution

The study introduces intraoperative transcholecystic methylene blue injection as a low-cost, simple technique for safer laparoscopic cholecystectomy.

## Key findings

- Methylene blue injection improved delineation of the gallbladder and biliary system during surgery.
- No cases of bile duct injury or conversion to open surgery were observed in the study.
- The technique is practical, affordable, and does not require special equipment or radiation.

## Abstract

Introduction

With the use of advanced instruments and techniques, the reported incidence of bile duct injury is low; however, the actual frequency might be slightly higher than reported. Most surgeons might encounter bile duct injury or bile duct-related complications in their early training days. Nevertheless, with newer techniques and technologies, cases of bile duct injuries have been mostly observed in open cholecystectomy. The predominant cause of injury is the misinterpretation of the anatomy of the bile duct, cystic duct, or aberrant right sectoral hepatic duct. Laparoscopic cholecystectomy is currently the gold standard of therapy for cholecystitis.

Materials and methods

The study was conducted in the Department of General Surgery at the Indira Gandhi Institute of Medical Sciences in Patna, after obtaining clearance from the ethics committee. The duration of the study was one year.

Results

A total of 50 patients were enrolled in the study, whose ages ranged from 20 to 55 years. They were predominantly female. The mean operative time was 68.5 ± 8.7 minutes. There were no cases of conversion to an open procedure, bile duct injury, or biliary stricture.

Conclusion

The injection of methylene blue into the gallbladder fundus during laparoscopic cholecystectomy is a practical, affordable, and simple procedure that does not require any special equipment or radiation exposure for the improved delineation of the gallbladder and biliary system. The use of intraoperative methylene blue could be a low-cost and simple alternative for safe laparoscopic cholecystectomy.