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Laparoscopic Common Bile Duct Exploration

they can be removed by endoscopic stone extraction or • Fall of hemoglobin
through the mature T-tube tract (some 4 weeks later). • Rarely empyema of gallbladder and death
Other techniques are also available. Laparoscopic trans- • Cardiac arrhythmias
cystic balloon dilatation of the Sphincter of Oddi (LTBDS). • Bacteremia.
It has the advantage of avoidance of sphincterotomy.
Percutaneous papillary balloon dilatation is another Chemical Methods
therapeutic option that can be performed prior to The chemical agents available are Ceruletide IV infusion.
laparoscopic cholecystectomy (LC) or on the operating table Methyl terbutyl ether (MTBE) and Mono octanoin can be
immediately after LC. Ductal calculi can be pushed into the used as dissolution agents.
duodenum safely and effectively by this technique. Combined CONCLUSION
laparoscopic and endoscopic treatment can also be done.
LCBDE is a technically feasible procedure with low
Intraoperative Fluorocholangiography complication and mortality rates, although it requires careful
patient selection and a variety of techniques and equipment.
It is a very effective technique for the demonstration of the Multiple modalities are available for the management of ductal
ductal system intraoperatively and for the detection of ductal calculi. Based on the clinical situation at hand, facilities
calculi. The rate of CBD injury is significantly lower when available and technical expertise, the ideal modality or
IOFC is used. Routine cholangiography allows the discovery modalities should be selected to treat the individual patient.
of concomitant common duct stones.
BIBLIOGRAPHY
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