(3) For concomitant intrahepatic and extrahepatic bile duct stones, laparoscopic liver resection, choledochoscopy
through the hepatic duct orifice on the hepatectomy cross-section, LCBDE, EST, or percutaneous transhepatic cholangioscopic lithotripsy could be used.
in common bile duct surgery for choledocholithiasis: A must.
In conclusion, direct POC using cholangioscopy, "mother-baby" choledochoscopy
, or ultra-slim endoscope allows direct visualization of large CBD stones during lithotripsy with laser.
Draganov, "The Usefulness of SpyGlass[TM] choledochoscopy
in the diagnosis and treatment of biliary disorders," Current Gastroenterology Reports, vol.
We describe a single operative treatment whereby, following laparoscopic cholecystectomy, laparoscopic CBD exploration via choledochotomy allowed retrieval of the retained basket and confirmation of duct clearance with choledochoscopy
. We have shown the approach to be both feasible and safe and, where surgical expertise permits, can reduce the risk of further treatment sessions to manage residual common bile duct stones or debris.
was done to identify the right and left segmental ducts and ensure the absence of intrahepatic stones.
Ultrasound scan, CT (Figure 1), MRI (Figure 2), MRCP, ERCP, intraoperative cholangiography, and choledochoscopy
all have been described in the literature for the preoperative work-up of BCA [42-46].
Biliary tree clearance was achieved either prior to surgery by ERCP or per-operatively by choledochoscopy
. All patients underwent laparoscopic cholecystectomy in standard way using four ports.
But routine application of choledochoscopy
or completion cholangiography plus the availability of ERCP for stone extraction have reduced those indications of T-tube.
In dealing with a deep seated abscess with a tortuous tract electrohydraulic lithotripsy in association with choledochoscopy
is a good alternative .
Three patients underwent choledochoscopy
confirming tissue necrosis and ablation after RFA, one of them at three months after RFA just before his second session of RFA.
Criteria for small stones (choledocholithiasis less than or equal to 3mm) included: multiple small gall bladder stones on ultrasound and evacuation of fine stones seen on ERCP after sphincterotomy or during intraoperative choledochoscopy