Tips and Tricks to Perform Intraoperative Cholangiogram during Single Incision Laparoscopy for Cholecystectomy

Jeremy Lee Kay Hock, Roxanne Teo and Stephen Chang Kin Yong

College of Medicine and Health, University College of Cork, Ireland
School of Medicine, University of Glasgow, Scotland
Glad Clinic, Mount Elizabeth Hospital, Singapore
Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

^*Correspondance to: Stephen Chang Kin Yong 

 PDF  Full Text DOI: 10.25107/2474-1647.2050

Abstract

Background: Laparoscopic Cholecystectomy (LC) has been the “gold standard” approach for the removal of gallbladder to treat gallstone disease since the early 1990’s. Routine Intraoperative Cholangiography (IOC) is often carried out during Conventional Laparoscopic Cholecystectomy (CLC) to visualise the biliary anatomy and enable prompt management of unanticipated Common Bile Duct (CBD) injuries. Single - Incision Laparoscopic Cholecystectomy (SILC) offers better cosmesis and reduced pain, which was reported by various groups. However, routine IOC is not performed during SILC due to technical difficulties. Our paper aims to describe a technique that could be utilised to perform IOC during SILC.Methods: A total of 18 patients who had undergone IOC during SILC via the umbilical port were studied in detail. Details of the operative methods and the results of IOC during SILC were discussed in this article.Results: All of our 18 patients successfully underwent IOC during SILC (100% success rate). A total of 15 patients’ IOC (83.3%) were normal and 2 patients’ IOC (11.1%) detected aberrant anatomy that involved the direct insertion of the sectoral duct into the common hepatic duct. Only 1 patient’s IOC (5.5%) reported the finding of a biliary stone in the lower end of the bile duct, and the patient required post - operative Endoscopic Retrograde Cholangiopancreatography (ERCP) for its removal.Conclusion: We believe that our technique is advantageous in that it does not require any additional ports or percutaneous needle puncture. It was also successfully performed in all 18 of our patients without any intraoperative complications.

Keywords

Single - incision Laparoscopic Surgery; Intraoperative Cholangiography; Cholecystectomy

Cite the article

Hock JLK, Teo R, Yong SCK. Tips and Tricks to Perform Intraoperative Cholangiogram during Single Incision Laparoscopy for Cholecystectomy. Clin Surg. 2018; 3: 2050.