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Laparoscopic Dormía Basket retrieval by choledochotomy plus primary closure using three ports: Case report of a hooked Dormía Basket during ERCP

Daniel Gomez, MD, FACS1, Luis F Cabrera, General Surgeon2, Andres Mendoza, General Surgeon2, Ricardo Villareal2, Mauricio Pedraza2, Jean Pulido2, Eric Vinck, MD2, Sebastian Sanchez2. 1CPO, 2Bosque University

Introduction: ERCP with endoscopic sphincterotomy (EN) and stone extraction with Dormia Basket or balloon catheters, is the current approach for the management of choledocholithiasis. Recently, there have been some uncommon complications associated with these conventional techniques, such as the retention of the Dormia basket inside the bile ducts or it´s rupture, mainly related to difficult stones (giant, multiple or intrahepatics stones), different to our case in which the Dormia Basket got hooked to the left hepatic duct during ERCP by a mechanism different to a stone impacted in the lumen of the duct. 

Methods: We present a video of a rare case managed with a laparoscopic approach using three ports to perform a biliary duct exploration plus Dormia Basket retrieval whit primary closure of the CBD.

Results: The case was carried out completely laparoscopically with a time of 45 min, an estimated blood loss of 10 cc, oral intake at the same day of surgery, the patient was discharged at 72 hours and in early follow up we didn´t registered a bile leak.

Conclusions: The laparoscopic approach for the management of this uncommon ERCP related complications, such as the one presented in our video using three ports for the CBD exploration and the subsequent primary closure, is a feasible and safe option as demonstrated in this case.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95356

Program Number: V414

Presentation Session: Video Loop Day 4

Presentation Type: VideoLoop

20

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