An alternative technique for laparoscopic cholangiography.
The current methods utilized for laparoscopic cholangiography involve cystic duct cannulation and present practical difficulties and potential hazards. An alternative method for intraoperative cholangiography is described which is easy, quick, and safe. The Kumar clamp (a gift from Sabi Kumar, M.D.) is placed across the infundibulum. A 23-gauge sclerotherapy needle is introduced through a side port in the clamp and directed into the infundibulum. The cholangiogram is obtained prior to any dissection in the triangle of Calot, thereby avoiding iatrogenic common bile duct injuries due to misidentification of the cystic duct or anomalous anatomy. To date no pathology has been missed and no complications have resulted from this technique.
Holzman
M D
MD
Department of General Surgery, Vanderbilt University School of Medicine, Nashville, TN 37232.
Sharp
K
K
Holcomb
G W
GW
Frexes-Steed
M
M
Richards
W O
WO
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002758:Cholangiography / Q000295:instrumentation* / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002764:Cholecystitis / Q000000981:diagnostic imaging* / Q000628:therapy; D002769:Cholelithiasis / Q000000981:diagnostic imaging* / Q000628:therapy; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003250:Constriction; D042882:Gallstones / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D015911:Sclerotherapy / Q000379:methods