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WJOLS
ORIGINAL ARTICLE Laparoscopic Common Bile Duct Exploration

Laparoscopic Common Bile Duct Exploration

TK Neelamekam, Premkumar Balachandran
Apollo Hospital, Chennai, Tamil Nadu, India

Abstract
Stones in the common bile duct are a common finding and is one of the most common cause for obstructive jaundice. These calculi may
be primary ductal stones or secondary, which descend from the gallbladder. There are various therapeutic options for its management
and could vary from chemical to surgical management. A combination of different methods is useful in those cases where isolated
techniques are not successful. Based on the clinical situation at hand, the facilities available and the level of technical expertise, one should
select the ideal modality for its successful management.
Keywords: Laparoscopic CBD exploration, ERCP, opne surgical exploration of CBD.

AIMS • No lymphadenopathy
• PR/ PV – NAD.
To present an interesting case of obstructive jaundice, its
investigation and management.
To discuss the various methods of management of Investigations
common bile duct stones, with a view to emphasize the • TC-10,100.
ideal treatment modality. • LFT’s – T. Bilirubin- 8.3, Direct- 5.6, Indirect- 2.7,

SGPT – 150, Alk. Phos.- 1380, GGTP- 385.
MATERIALS AND METHODS
• USG – Thick walled gallbladder, dilated CBD, IHBR,
An interesting case of obstructive jaundice encountered by with multiple calculi.
us in our clinical practice is mentioned here with its • MRCP – Thick walled gallbladder, dilated CBD, IHBR,
investigations and management. filled with multiple calculi (Fig. 1).
A literature search on PubMed and Google was done
using the keywords laparoscopy, common bile duct stones,
obstructive jaundice, ERCP, lithotrispy, chemical
dissolution.

CASE REPORT
A 44-year-old lady was admitted with abdominal pain,
yellowish discoloration of eyes and itching of skin for one
month. She also complained of loss of appetite, nausea and
pale colored stools. She had no other significant past history.
She was not a diabetic or hypertensive.
On examination:
• Obese, short statured lady
• Febrile
• Icterus + +
• R subcostal tenderness +
• No mass
• No organomegaly
• No free fluid Fig. 1: MRCP showing dilated biliary dutcal system with multiple calculi

World Journal of Laparoscopic Surgery, May-August 2010;3(2):59-62 59