Biliary Tract Anatomy, Common Bile Duct Stones., Gall Stone Disease, Laparoscopic Cholecystectomy
Conditions
Keywords
Laparoscopic cholecystectomy, Intra-operative cholangiography
Brief summary
Standard cystic duct cholangiography (CDC) during laparoscopic cholecystectomy can be difficult, time consuming and bile duct injury may be caused by attempts to cannulate the cystic duct. Operative cholangiography performed by direct puncture of the gall bladder fundus or Cholecystocholangiography (CCC) is a valid and easier alternative.
Detailed description
This study was conducted on 60 patients with symptomatic gall bladder stones undergoing laparoscopic cholecystectomy. Patients were randomized into two groups: Group (1) was evaluated by cholecyst-cholangiography by puncture through the gall bladder fundus. Group (2) was evaluated for the standard cystic duct cholangiography.Cholangiography was considered successful if it could be performed with complete delineation of the biliary tree with flow of the dye through the duodenum occurred. It is to be noted that inability to cannulate the cystic duct for example, is considered a failure.
Interventions
PROCEDUREcholecystocholangiography
a central venous pressure catheter was introduced through the anterior abdominal wall subcostally in a direction parallel to the gallbladder bed under direct vision so that it emerges close to the gall bladder. Then the catheter was advanced into the fundus of the gall bladder . The dye was prepared by diluting 20ml of 76% urografin with 20ml normal saline in a 50ml syringe
PROCEDUREcystic duct cholangiography
Then a 14G cannula was introduced through the anterior abdominal wall subcostally, (size 4F), was introduced through this cannula. The catheter was inserted into the cystic duct no more than 1 cm, by a grasper Then a 50ml syringe with the diluted urografin dye, as above, was attached to the catheter and cholangiography was performed by slowly injecting the dye under control of C-arm image intensifier.
Sponsors
Theodor Bilharz Research Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* patients with symptomatic gall bladder stones.
Exclusion criteria
* unfit Patients and/or had previous surgery * history of obstructive jaundice and acute attacks or previous ERCP were excluded
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| success rate | 6 months |
Secondary
| Measure | Time frame |
|---|---|
| procedure-related complications | 3 months |
Countries
Egypt
Outcome results
None listed