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    Add as FriendTransdochal CBD exploration

    by: Rogers

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    1 : Transdochal CBD exploration Prof Rajeev Sinha HOD MLB Medical College JHANSI
    2 : Aim Feasibility study Assessment of operative parameters Assessment of postoperative parameters Methodology 32pts 4mm-0deg-urethroscope OR 17FG-6deg-nephroscope 5 ports
    3 : Dissected CBD - Incision with endoknife / harmonic / cautery Ligated Cystic duct
    4 : CHD and Intrahepatic biliary channels Stone in distal CBD Nephroscopic view
    5 : 4 mm Stone crusher in use Fragmented stone
    6 : Intact stone removal –using grasper Post stone removal Normal Ampullary opening seen
    7 : T- tube in place - optional
    8 : Closure without T tube
    9 : 45 -105 min T tube in -7 pts Morrison’s pouch drain- ALL pts Discharge – 4 d Results Bile drainage > 4days (1)pt Port site infection (2) Retained stones (2) Conversion (5) COMPARABLE TO OPEN CBD EXPLORATION RESULTS
    10 : CONCLUSIONS Requires advanced Lap expertise Significant increase in operating time BUT Marked reduction in morbidity THANK YOU

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