scholarly journals Fractured T Tube Fragment in Common Bile Duct during Retrieval: An Unforeseen Mishap

2021 ◽  
Vol 07 (03) ◽  
pp. e251-e254
Author(s):  
Deepak Rajput ◽  
Itish Patnaik ◽  
Sruthi Shasheendran ◽  
Beeram K. Prasanna Kumar ◽  
Amit Gupta
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Balloon Catheter ◽  
Bile Leak ◽  
Biliary Fistula ◽  
Intraluminal Pressure ◽  
Endoscopic Retrograde ◽  
T Tube ◽  
Cbd Exploration

AbstractCommon bile duct (CBD) exploration by surgical method—open or laparoscopic, traditionally involved using a T tube to take care of postoperative intraluminal pressure and edema. The complications of T tube include bile leak after removal, formation of biliary fistula, excoriation of the skin, dehydration, saline depletion, retained T tube fragment, CBD obstruction, cholangitis, pancreatitis, and duodenal erosion. Here, we report a case of retained T tube fragment after an attempted removal in an operated case of choledocholithiasis, which was managed by endoscopic retrograde cholangiopancreatography and balloon catheter removal of the remnant.

scholarly journals Laparoscopic Common Bile Duct Exploration for Retrieval of Impacted Dormia Basket following Endoscopic Retrograde Cholangiopancreatography with Mechanical Failure: Case Report with Literature Review

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
J. W. O’Brien ◽  
R. Tyler ◽  
S. Shaukat ◽  
A. M. Harris
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Common Bile Duct Exploration ◽  
Fogarty Catheter ◽  
Endoscopic Retrograde ◽  
Laparoscopic Case ◽  
The Common ◽  
Laparoscopic Cbd Exploration ◽  
Cbd Exploration

Dormia baskets are commonly used during endoscopic retrograde cholangiopancreatography (ERCP). One complication is basket retention, through impaction with a gallstone or wire fracture. We describe a case where the external handle of the basket snapped causing retained basket plus large gallstone impacted in the common bile duct (CBD). Following laparoscopic cholecystectomy, laparoscopic CBD exploration allowed direct stone fragmentation under vision with the choledochoscope. Fragments were removed using a choledochoscopic basket and Fogarty catheter, and the basket was withdrawn. Literature search identified 114 cases of retained baskets with management including shockwave lithotripsy (27%), papillary balloon dilatation (22%), open CBD exploration (11%), and one laparoscopic case.

scholarly journals Experience with laparoscopic common bile duct exploration in failed endoscopic retrograde cholangiopancreatography cases at a tertiary care hospital

2020 ◽  
Vol 7 (10) ◽  
pp. 3344
Author(s):  
Pradeep Panwar ◽  
Hetish M. Reddy ◽  
Rajendra Bagree ◽  
Gaurav Jalendra
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Tertiary Care ◽  
Bile Leak ◽  
Common Bile Duct Exploration ◽  
Care Hospital ◽  
Early Recovery ◽  
Endoscopic Retrograde ◽  
Tube Removal

Background: Minimally invasive techniques for stone removal in common bile duct (CBD) are endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC) or laparoscopic CBD exploration with LC (laparoscopic common bile duct exploration (LCBDE) and LC). Failed, multiple attempted or complications of ERCP leads to other surgical approaches where LCBDE is a preferable option by experts due to its added benefits.Methods:  We did LCBDE and LC in 40 cases of failed ERCP. Standard investigation protocol was followed in all cases and CBD were explored laparoscopically and stones were retrieved. Post retrieval choledochoscopy was done and sphincter of oddi was dilated by the dilators.Results: With careful selection of cases, stone calculi were retrieved successfully in 38 cases by laparoscopically and 2 cases by open method after conversion. Postoperative choledochoscopy were found normal. Bile leak seen in 3 cases, which were managed conservatively. Standard regime of postoperative care was taken followed by T-tube removal after cholangiogram on day 10-14. All patients survived the operation.Conclusion: We advocate that LCBDE is the most viable alternative for open surgery in failed ERCP cases for retrieval of CBD stones. This results in early recovery, better cosmetic scar, least complications with early resumption of routine life. Needs cautious patient selection and expertise in laparoscopic surgery.

scholarly journals Endoscopic Fistulotomy – ‘The Suprapapillary Punch’: A Method of Access to the Bile Duct during ERCP

1994 ◽  
Vol 8 (1) ◽  
pp. 33-35
Author(s):  
Noel B Hershfield
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Biliary Tree ◽  
Usual Method ◽  
Endoscopic Retrograde ◽  
The Common ◽  
A Minor ◽  
Endoscopic Fistulotomy

Endoscopic retrograde cholangiopancreatography (ERCP) is established as the method of choice to investigate the biliary tree when obstruction is suspected. On rare occasions, the papilla cannot be entered because of anatomical or pathological abnormalities. This report describes endoscopic fistulotomy or the suprapapillary punch that has been carried out at the Foothills Hospital in Calgary, Alberta, on 30 of 623 patients referred for ERCP for conditions causing obstruction of the common bile duct or suspected obstruction of the common bile duct. The following communication also describes the method of suprapapillary punch or endoscopic fistulotomy. Results have been excellent with only one complication, a minor attack of pancreatitis after the procedure. In summary, the suprapapillary punch or fistulotomy is a safe and useful method for entering the common bile duct when access by the usual method is impossible.

scholarly journals Management of choledocholithiasis after previous gastrectomy

2017 ◽  
Vol 99 (7) ◽  
pp. e213-e215
Author(s):  
S Anwer ◽  
R Egan ◽  
N Cross ◽  
S Guru Naidu ◽  
K Somasekar
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Successful Management ◽  
Endoscopic Retrograde ◽  
Technical Challenge

Common bile duct stones in patients with a previous gastrectomy can be a technical challenge because of the altered anatomy. This paper presents the successful management of two such patients using non-traditional techniques as conventional endoscopic retrograde cholangiopancreatography was not possible.

scholarly journals LAPAROSCOPIC CHOLEDOCH REVISION FOR THE TREATMENT OF CHOLEDOCHOLITHIASIS IN AN INFANT

2019 ◽  
Vol 23 (4) ◽  
pp. 220-223
Author(s):  
M. Yu. Kozlov ◽  
Anton S. Malashenko ◽  
A. A. Shchebeteev
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Bile Ducts ◽  
Open Abdomen ◽  
Unified Approach ◽  
Endoscopic Retrograde ◽  
Surgical Practice ◽  
Percutaneous Puncture ◽  
The Common

Choledocholithiasis is a rare pathology in children. Various techniques have been proposed for removing calculi from the common bile duct: percutaneous puncture drainage of bile ducts, endoscopic retrograde cholangiopancreatography with papillosphincterotomy as well as revision of the common bile duct which can be done laparoscopically or in the open abdomen. However at present, there is no any unified approach to managing this pahtology in children. The article describes authors’ experience of laparoscopic revision of the common bile duct in an infant with choledocholithiasis. The authors consider that this technique can be applied in pediatric surgical practice.

scholarly journals Laparoscopic CBD Exploration (LCBDE) a better and safe option for large CBD stones

2021 ◽  
Vol 15 (6) ◽  
pp. 1321-1323
Author(s):  
I. Sadiq ◽  
A. Malik ◽  
J. K. Lodhi ◽  
S. T. Bukhari ◽  
R. Maqbool ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Bile Leak ◽  
Common Bile Duct Stones ◽  
Common Bile Duct Exploration ◽  
Open Approach ◽  
Cbd Stones ◽  
Duration Of Surgery ◽  
Laparoscopic Cbd Exploration ◽  
Cbd Exploration

Background: Conventionally, common bile duct stones (CBDS) are removed with help of ERCP. However, if CBDS are larger than 10 mm, then the ERCP failure rate to retrieve CBDS becomes high. In that case, open or laparoscopic common bile duct exploration (LCBDE) is other alternative. In this era of minimally invasive surgery, laparoscopic CBD exploration (LCBDE) seems to be a better option than open approach, but in our set up the safety of LCBDE is questioned. Aim: To see the conversion rate as well as complications associated with LCBDE. Material & Methods: Methods: This is a retrospective analysis of data of patients who underwent Laparoscopic Common Bile Duct Exploration (LCBDE) for large CBD stones at Fatima Memorial Hospital Lahore. Results: Since 2012, 29 patients of large (≥10 mm) CBD stones were included in this study. Among them 20(69.9%) were females and 9(31.01%) were males. The mean CBD stone size was 13 mm. Stones were extracted transcystically in 4 case and Transcholedochal stone extraction was done in 25 cases. The average duration of surgery was 130 minutes, but all cases were completed successfully without converting to open approach. There was minor bile leak in 3 patients which was managed successfully without any further intervention. No other complication was observed with LCBDE and even no retained stone was reported. Conclusion: Laparoscopic CBD exploration is safe and effective method of dealing CBD stones especially of large size when the chances of ERCP failure to retrieve stones are high. Keywords: Laparoscopy, ERCP, common bile duct,

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