cholangiogram

Keywords: Biliary intervention, Biliary malignancy, Cholangiogram, Obstructive jaundice, Percutaneous biliary drainage.

All operative procedures of elective laparoscopic cholecystectomies done on adult patients of age 18 years or above from 1st August 2013 till 31st December, 2013 were included in the study whereas those which had any other procedure performed simultaneously, had intraoperative cholangiogram (IOC/POC) or converted to open were excluded to keep the homogeneity.

Common sequelae of the mass appear to be sclerosing cholangitis, and both were diagnosed on a cholangiogram. Some reports suggest that the presence of sclerosing cholangitis, especially in children, should raise a suspicion for LCH (11,12).

But when there is suspicion intraoperatively, intraoperative cholangiogram is to be done whenever there is a possibility and repair to be done in the most appropriate way.

Subsequently the patient underwent an image-guided percutaneous cholangiogram and cholecystostomy drain placement by interventional radiology.

Caption: Figure 11: ERCP following several sweeps with flower basket demonstrating clearance of the hemobilia and resultant air cholangiogram. A self-expanding metallic stent is also noted in the biliary tree, which helps maintain luminal patency and flow.

Cholangiogram revealed a large stone at the cystic duct and a smaller filling defect at the distal common bile duct (CBD) (Figure 2).

Several factors can contribute to failure, namely, severe inflammatory or malignant strictures, obstruction of the neck of the gallbladder by impacted stones, tortuosity of the duct, and cystic duct outlet not visible on the cholangiogram. These high rates of technical success may be attributable to the level of skills gained by performing many of these procedures.

The data collected for this study included demographic details and operative details including timing of the procedure (AM or PM list), length of operation, use of on-table cholangiogram, insertion of drains, intraoperative complications, time of leaving theatre recovery, grade of operating surgeon, and any immediate postoperative complications.

Cholangiogram showed a dilated CBD with prepapillary CBD stricture.

On endoscopic retrograde cholangiopancreatography, the cholangiogram was normal ruling out extrahepatic cholestatic disorders.

Laparoscopic cholecystectomy was carried out uneventfully and operative cholangiogram revealed no stones in the common bile duct (CBD).