Primary Closure of CBD Over an Antegrade Stent After Laparoscopic CBD Exploration

Laparoscopic common bile duct exploration (LCBDE) has been found to be a safe, efficient and cost-effective treatment for choledocholithiasis. Following LCBDE, the clearance may be ascertained by a cholangiogram or choledochoscopy. The common bile duct (CBD) may be closed primarily with or without a stent in situ or may be drained by means of a T-tube or a biliary enteric anastomosis. In our experience, a single stage laparoscopic treatment of cholelithiasis with choledocholithiasis is a safe, viable and cost-effective option. Closure of the CBD over an antegrade stent is a feasible option but requires advanced skills in minimal access surgical techniques, especially endosuturing.

In this video you see:

Acute on chronic fibrotic gallbladder.Cystic artery arise from accessory right hepatic arteryLaparoscopic common bile duct exploration and choledochoscopy.Use of Stapling Devices for Safe cystic duct closure in Acute Cholecystitis. Common bile duct stenting. Intra-operative endoscopy (hybrid flxible endolaparoscopy). Primary closure of CBD over an antegrade stent.