Adel Alhaj Saleh, MD, MRCS, Edwin O Onkendi, MBChB. Texas Tech University, Health Sciences Center
- The patient recovered smoothly and was gradually advanced to full diet and was discharged on POD#1
- He was seen in the clinic 2 weeks after the procedure had no issues.
- Pathology was benign
- The CBD stent was removed 4 weeks postoperatively by ERCP
Patient # 1:
- A 52 year-old female with h/o Roux-en-ygastric bypass
- Presented with right upper quadrant abdominal pain x3 days associated with vomiting
- She was found to have acute cholecystitis with high wbccount.
- PMH: breast cancer, DM, MDD, HTN , Dysilpidimia
- PSH: Mastectomy, Roux-en-ygastric bypass
- She also has increased bilirubin
- Abdominal USS showed bile duct stones and dilated common bile duct.
- A previous attempt at ERCP had failed due to prior gastric bypass.
- The patient was planned for robot-assisted cholecystectomy and common bile duct exploration
- Robotic CBD exploration after Roux-en-Y gastric bypass is a great alternative to laparoscopic assisted intraoperative ERCP for clearance of bile duct stones.
- In morbidly obese patients robotic CBD exploration, is much less challenging than laparoscopic approach and provides the patient a minimally invasive clearance of CBD stones that would otherwise require open CBD exploration
- The Patient had an uneventful postoperative course
- Gradually advanced to full diet and was discharged on POD #2
- Scheduled to be seen in the clinic in 1 month.
Patient # 2:
- A 53-year-old morbidly obese male presented with obstructive jaundice
- CT scan of the abdomen showed multiple common bile duct stones and cholelithiasis.
- Bilirubin was 14.
- Attempt at ERCP wasn’t successful because he had large stones, with one mid bile duct stone causing obstruction and bile duct dilatation and multiple other large stones.
- Robotic common bile duct exploration, choledechotomy, removal of 7 large stones
- Robotic Cholecystectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91787
Program Number: V335
Presentation Session: Video Loop Day 3
Presentation Type: VideoLoop