[Laparoscopic transcystic biliary calculus extraction with Dormia basket]

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Biliary Tract Surgery

Context:

• Laparoscopic cholecystectomy (LC) is common, but unexpected common bile duct (CBD) stones can complicate the procedure.
• Intraoperative cholangiography (IOC) is selectively used to identify these stones.
• Managing unexpected CBD stones during LC requires effective and safe extraction techniques.

Purpose:

• To describe the transcystic extraction of common bile duct stones using a Dormia basket during laparoscopic cholecystectomy.
• To evaluate the indications, difficulties, and outcomes of the Dormia basket method for unexpected CBD stones.
• To propose the Dormia basket technique as an alternative treatment option.

Summary:

• The study details transcystic common bile duct (CBD) stone extraction with a Dormia basket in patients undergoing laparoscopic cholecystectomy (LC) who were found to have unexpected CBD stones.
• Selective intraoperative cholangiography (IOC) was performed. Stone extraction was successful in five patients; one conversion to open surgery was necessary due to stone size.
• One case of mild postoperative acute pancreatitis occurred, with no other complications reported. The Dormia basket method is evaluated for its effectiveness and challenges.

Impact:

• Demonstrates the feasibility and success rate of Dormia basket extraction for unexpected CBD stones during LC.
• Suggests a minimally invasive alternative to open surgery for managing intraoperative CBD stones.
• Highlights the potential to reduce operative time and patient recovery by addressing CBD stones during LC.