Dr Pradeep Jain -HEPATOBILIARY- Laparoscopic CBD Exploration with Choledochoduodenostomy
- 10 years ago
Patient and Port position: Patient placed in modified Lloyd Davies position
Pneumoperitoneum created by veress needle through 10 mm Supraumbilical skin incision which was later on converted into 10mm camera port. 10 mm epigastric, 5 mm right and 10 mm left midclavicular line ports, 5 mm right anterior axillary line ports were made.
STEPS :
Initial step is to visualize all quadrants of peritoneal cavity, liver surfaces and hepatoduodenal ligament.
Calot’s triangle dissected. Cystic artery dissected clipped with LT300 and divided. Cystic duct ligated by 3-0 silk suture. CBD dissected from surrounding structures. Stay sutures taken over CBD and choledochotomy done.
Multiple stones extracted from CBD lumen. CBD clearance checked by choledochoscope. 2cm transverse incision given over duodenum (D1). Choledochoduodenostomy done by interrupted 2-0 PDS sutures.
Gall gladder dissected from gall bladder fossa.
Pneumoperitoneum created by veress needle through 10 mm Supraumbilical skin incision which was later on converted into 10mm camera port. 10 mm epigastric, 5 mm right and 10 mm left midclavicular line ports, 5 mm right anterior axillary line ports were made.
STEPS :
Initial step is to visualize all quadrants of peritoneal cavity, liver surfaces and hepatoduodenal ligament.
Calot’s triangle dissected. Cystic artery dissected clipped with LT300 and divided. Cystic duct ligated by 3-0 silk suture. CBD dissected from surrounding structures. Stay sutures taken over CBD and choledochotomy done.
Multiple stones extracted from CBD lumen. CBD clearance checked by choledochoscope. 2cm transverse incision given over duodenum (D1). Choledochoduodenostomy done by interrupted 2-0 PDS sutures.
Gall gladder dissected from gall bladder fossa.