Adel Alhaj Saleh, MD, MRCS, Edwin Onkendi, MBChB. Texas Tech University Health Sciences Center
A 52 year-old female presented to an outside institution with 1 year history of right upper abdominal pain
She also had unintentional weight loss.
CT scan with contrast showed a porcelain gall bladder
A laparoscopic cholecystectomy was attempted at that institution.
Intraoperatively, the gallbladder wall was hard and was thought to be adherent to the common bile duct.
Due to the risk of injury to the common bile duct, the surgeon at the outside institution appropriately aborted the procedure and referred the patient to our center, to be managed by a hepatobiliary surgeon.
The patient was taken to OR for robotic cholecystectomy under indocyaninegreen cholangiography guidance
Indocyaninegreen cholangiography aided better visualization of the bile duct and guided dissection of the gallbladder off of it.
The Patient had an uneventful postoperative course
Gradually advanced to full diet and was discharged on POD #1
Was seen in the clinic 2 weeks after the procedure and had no issues.
The pathology report was benign.
Robotic approach for cholecystectomy of porcelain gallbladder adherent to bile duct aided by indocyaninegreen cholangiography was especially useful and safe in this case to prevent bile duct injury.
Also the ability to retract and achieve exposure without need to grasp the hard porcelain gallbladder made the robotic approach best as opposed to laparoscopic approach.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 96060
Program Number: V401
Presentation Session: Video Loop Day 4
Presentation Type: VideoLoop