Mostafa El-Beheiry1, Steven MacLellan2. 1Western University, 2University of Toronto
This is a case of a laparoscopic common bile duct exploration in a patient who is status post total gastrectomy with Roux-Y reconstruction for T2N0 gastric cancer. He presented to the emergency department with epigastric pain and tenderness and elevated liver enzymes. MRCP demonstrated a distal CBD filling defect. Due to his gastrectomy and reconstruction, ERCP was not possible and therefore a laparoscopic common bile duct exploration was undertaken. He had significant left upper quadrant and midline adhesions. A transcystic cholangiogram was performed followed by a choledochotomy under direct vision guided by fluoroscopy. Multiple large stones were extracted. A cystoscope was used to visualize the ducts.The choledochotomy was closed with a 3-0 absorbable stitch in a running fashion. A surgical drain was placed. The patient was discharged home on post-op day number 3 with an uneventful post-op course, the drain was removed prior to discharge.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80744
Program Number: V164
Presentation Session: Case Presentations
Presentation Type: Video