Laparoscopic transcystic common bile duct exploration.
This study reviews the results of transcystic common bile duct exploration (CBDE) for unsuspected stones found during laparoscopic cholecystectomy by a single surgeon in 150 consecutive patients. Fluoroscopic cholangiography was attempted in all but four patients. If the cholangiogram appeared to show common bile duct (CBD) stones, a 5 Fr, 8-mm ureteral stone basket was passed through the cystic duct into the duodenum, opened, and trolled through the CBD. Routine cholangiography was successful in 131 of 144 attempts (90%). An indication for CBDE was found by cholangiogram in seven patients (5%). Two cholangiograms were falsely positive. Stones were removed in five patients. Completion cholangiograms were normal in all patients. One patient developed mild pancreatitis but was discharged 2 days after laparoscopic cholecystectomy. The remainder were discharged on postoperative day 1. One patient was readmitted on postoperative day 2, possibly having passed a retained stone. Fluoroscopic CBDE was successful in clearing the CBD in all patients in this small series and deserves further evaluation.
Hunter
J G
JG
Department of Surgery, University of Utah Medical Center, Salt Lake City 84132.
D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D003135:Common Bile Duct / Q000000981:diagnostic imaging / Q000601:surgery; D003549:Cystic Duct; D005471:Fluoroscopy; D042882:Gallstones / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy