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Related Experiment Videos

A modified transcystic biliary decompression after laparoscopic choledochotomy.

Qi Wei1, Xiujun Cai, Jin Yang

  • 1Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China. weiqi@hzcnc.com

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|March 24, 2004
PubMed
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A new method for Transcystic Biliary Decompression (TCBD) after Laparoscopic Choledochotomy (LCD) using a ureteral catheter and Lapro-Clip is safe and effective. This technique allows patients to recover quickly without drainage tubes, improving outcomes for common bile duct stones.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Minimally Invasive Surgery

Background:

  • Transcystic Biliary Decompression (TCBD) offers an alternative to T-tube placement after Laparoscopic Choledochotomy (LCD).
  • Traditional TCBD methods have drawbacks, potentially negating the benefits of minimally invasive surgery.
  • A novel approach using a ureteral catheter and Lapro-Clip is presented to enhance TCBD security and efficacy.

Purpose of the Study:

  • To introduce and evaluate a new, secure method for Transcystic Biliary Decompression (TCBD) following Laparoscopic Choledochotomy (LCD).
  • To assess the safety, efficacy, and ease of use of this modified TCBD technique.
  • To determine if this method facilitates early patient discharge without complications.

Main Methods:

  • A 5 Fr ureteral catheter was inserted into the common bile duct (CBD) via the cystic duct in 19 patients undergoing LCD.

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  • The ureteral catheter was secured using an absorbable 12 mm Lapro-Clip.
  • The choledochotomy was then primarily closed, and the catheter served for biliary decompression.

    • Main Results:

    • The average postoperative bile output was 256 mL/day.
    • The median postoperative hospital stay was 5 days, with catheter removal between 3 to 7 days.
    • No early complications such as bile leak, clip slippage, occlusion, or catheter dislodgment were observed.

    Conclusions:

    • The modified TCBD technique using a ureteral catheter and Lapro-Clip is safe, effective, and simple to perform.
    • This approach enables patients to be discharged within a week without the need for external drainage tubes.
    • This method is proposed as a viable option for managing patients with common bile duct stones.