{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T21:47:34Z","timestamp":1771019254105,"version":"3.50.1"},"reference-count":32,"publisher":"International College of Surgeons","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014]]},"abstract":"Abstract<\/jats:title>\n Many techniques are described for the ligation of a difficult cystic duct (CD). The aim of this study is to assess the effectiveness and safety of stapling of a difficult CD in acute cholecystitis using Endo-GIA. From January 2008 to June 2012, 1441 patients with cholelithiasis underwent laparoscopic cholecystectomy (LC) at the Department of General Surgery, Haydarpasa Numune Education and Research Hospital. Of these, 19 (0.62%) were identified as having a difficult CD and were ligated using an Endo-GIA stapler. All patients were successfully treated with a laparoscopic approach. The length of hospital stay was 3.4 days. There were umbilical wound infections in 4 patients (21%). The length of follow-up ranged from 1.0 to 50.4 months. In conclusion, Endo-GIA is a safe and easy treatment method for patients with a dilated and difficult CD. The cystic artery should be isolated and ligated if possible before firing the Endo-GIA stapler. If isolation and stapling are not possible, fibrin sealant can be applied to avoid bleeding. The vascular Endo-GIA can be applied in a large CD, but for acute cholecystitis with an edematous CD, the Endo-GIA roticulator 4.8 or 3.5 stapler is preferred.<\/jats:p>","DOI":"10.9738\/intsurg-d-14-00035.1","type":"journal-article","created":{"date-parts":[[2014,12,8]],"date-time":"2014-12-08T16:00:08Z","timestamp":1418054408000},"page":"571-576","source":"Crossref","is-referenced-by-count":11,"title":["Use of Stapling Devices for Safe Cholecystectomy in Acute Cholecystitis"],"prefix":"10.9738","volume":"99","author":[{"given":"Mehmet","family":"Odabasi","sequence":"first","affiliation":[{"name":"Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. A. Tolga","family":"Muftuoglu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erkan","family":"Ozkan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cengiz","family":"Eris","sequence":"additional","affiliation":[{"name":"Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet Kamil","family":"Yildiz","sequence":"additional","affiliation":[{"name":"Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emre","family":"Gunay","sequence":"additional","affiliation":[{"name":"Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haci Hasan","family":"Abuoglu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kemal","family":"Tekesin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sami","family":"Akbulut","sequence":"additional","affiliation":[{"name":"Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4721","reference":[{"issue":"3","key":"i0020-8868-99-5-571-b01","series-title":"Am J Surg","first-page":"385","article-title":"The European experience with laparoscopic cholecystectomy","volume":"161","author":"Cushieri\n A,","year":"1991","unstructured":"Cushieri\n A, \n \n Dubous\n F, \n \n Mouiel\n J, \n \n Mouret\n P, \n \n Becker\n H, \n \n Buess\n G\n \n et al\n . 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Application of an Endo-GIA for ligation of the cystic duct during difficult laparoscopic cholecystectomy. 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