The Diagnosis of Post-Cholecystectomy Cystic Duct Fistula Utilizing Endoscopic Retrograde Cholangiopancreatography

Background: The meticulous identification of the hepatobiliary tree system normal anatomy during surgical operations is crucial in iatrogenic injury prevention. Equally important, an understanding of the congenital variations of biliary and vascular anatomy, as the literature abounds with reports of specific anatomical variations, and their surgical implications.Aim: This study aimed to study the presence of anatomical variations within the hepatobiliary system in Sudanese population undergoing endoscopic retrograde cholangiopancreatography (ERCP).Patients and methods: The records of patients undergoing ERCP in Soba University Hospital during 2004 to 2008 were analyzed. There were 277 Sudanese patients who had complained of right hypochondrial abdominal pain & history of jaundice (obstructive jaundice) that underwent ERCP were included within this study. The exclusion criteria included the following: Sudanese patients in whom ERCP failed or patients who had advanced hepatobiliary disease like cancers, strictures either cancerous or iatrogenic, fistula and iatrogenic biliary leak.Results: The analysis of 277 Sudanese patients undergoing ERCP of the hepatobiliary system showed the following results regarding the variations: The choledochal cyst type one (fusiform type) was present in 3 (1.08%) patients; very low cystic duct insertion (parallel) was present in 1 (0.36%) patient and long cystic duct was present in 3 (1.08%) patients. The ampulla of Vater size variations occurred as A) Normal in 158 (57%) patient, B) Small in 56 (20.2%) patients, C) Large in 29 (10.5%) patients, D) Periampullary diverticula in 4 (1.4%) patients and E) unclassified in 30 (10.8%) patients. Other forms of congenital anomalies were not found.Conclusion: The using of endoscopic retrograde cholangiopancreatography (ERCP) is a reliable radiological method for depicting congenital anomalies of the hepatobiliary system, but it is an invasive procedure.

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Laparoscopic Common Duct Exploration in 90-Bed Rural Hospital

The American Surgeon ◽

10.1177/000313481007600628 ◽

2010 ◽

Vol 76 (6) ◽

pp. 626-629

Author(s):

Eugene H. Shively ◽

Malcolm Richardson ◽

Robert Romines ◽

Graham Englund ◽

James Watkins

Keyword(s):

Laparoscopic Cholecystectomy ◽

Bile Duct ◽

Common Bile Duct ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Cystic Duct ◽

Common Duct ◽

Biliary Tract Disease ◽

Common Bile Duct Exploration ◽

Endoscopic Retrograde ◽

Tract Disease

Laparoscopic common bile duct exploration (LCBDE) is an effective procedure when endoscopic retrograde cholangiopancreatography is not available. From January 2004 until December 2009, 1254 patients presented with biliary tract disease. Laparoscopic cholecystectomy was attempted in 1240 (98%) cases and completed in 1232 (98%) cases. Laparoscopic cholangiograms were performed in 627 (50%) cases. LCBDE was carried out in 33 (2.6%) cases. Of the 33 LCBDEs, 29 (2.3%) were via the cystic duct, four (0.32%) through a choledochotomy; eight (0.64%) of the total laparoscopic cholecystectomies were converted to open cholecystectomies. LCBDE can be done safely in small hospitals and is very useful when endoscopic retrograde cholangiopancreatography is not available.

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Cystic duct remnant stone removal by endoscopic retrograde cholangiopancreatography

Journal of Digestive Endoscopy ◽

10.4103/0976-5042.189153 ◽

2016 ◽

Vol 07 (02) ◽

pp. 065-067 ◽

Cited By ~ 1

Author(s):

Yogesh Harwani ◽

Mahesh Goenka ◽

Vijay Rai ◽

Usha Goenka

Keyword(s):

Laparoscopic Cholecystectomy ◽

Bile Duct ◽

Common Bile Duct ◽

Obstructive Jaundice ◽

Female Patient ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Cystic Duct ◽

Endoscopic Retrograde ◽

Biliary Pain ◽

Postcholecystectomy Syndrome

AbstractCystic duct remnant calculus (CDRC) is an important cause of postcholecystectomy syndrome.[1] Open assess cholecystectomy or laparoscopic cholecystectomy of the remnant duct is effective and considered to be preferred treatment. We report a case of 65-year-old female patient, a poor surgical candidate with CDRC who presented to us with biliary pain and obstructive jaundice secondary to common bile duct (CBD) stones, in whom CDRC was extracted during CBD clearance by endoscopic retrograde cholangiopancreatography.

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Clearance of Cystic Duct Remnant Stones Using a SpyGlass Retrieval Basket during Single-Operator Cholangioscopy at ERCP

Journal of Digestive Endoscopy ◽

10.1055/s-0040-1715282 ◽

2021 ◽

Vol 12 (01) ◽

pp. 056-057

Author(s):

James Hawken ◽

Jim Portal

Keyword(s):

Endoscopic Retrograde Cholangiopancreatography ◽

Cystic Duct ◽

Extraction Method ◽

Surgical Intervention ◽

Stone Extraction ◽

Endoscopic Retrograde ◽

Electrohydraulic Lithotripsy ◽

Single Operator

AbstractExtraction of stones from a cystic duct remnant following cholecystectomy poses a significant therapeutic dilemma. Surgical intervention has historically been required due to difficulty accessing the cystic duct remnant during conventional endoscopic retrograde cholangiopancreatography. Single-operator cholangioscopy can access the cystic duct remnant, enabling electrohydraulic lithotripsy and stone extraction. Method of stone extraction has seldom been described in this developing field. Clearing duct remnant stones using guidewire placement and an extractor balloon have been reported. This is the first reported case of cystic duct remnant stone extraction using a SpyGlass retrieval basket.

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