Because ERCP is so widely accessible, this surgery is less frequently recommended. When ERCP fails or when intra-operative cholangiography indicates bile duct stones, it is carried out. The procedure is virtually invariably a cholecystectomy adjunct, and the approach and closure are identical. Correct any clotting issues, administer vitamin K, and use mannitol to keep the diuresis going in cases of obstructive jaundice. Apply preventative antibiotics to the area. 'Kocherise' (mobilize) the duodenum after the gallbladder has been removed. The CBD should then be seen above the first section of the duodenum by opening the peritoneum. At the level of the middle of the CBD, sew two stay sutures. Right-angled Pott's scissors and a pointed scalpel are used to expand the incision by roughly 2 cm while opening the CBD vertically. Stones and even bile will leak out of the hole. Milk the CBD from below and collect stones as they come out of the choledochotomy by placing your fingers behind the duodenum and head of the pancreas.
For more details please contact us at 9650099105.
