CHOLEDOCHOSCOPY WITH DUCTAL LAVAGE FOLLOWING FAILED ERCP FOR COMPLETE BILIARY OBSTRUCTION
Sarah Alfieri1, Natalie A. Burkert*1, Salvatore Docimo2,1, Joseph Sujka2,1
1University of South Florida Morsani College of Medicine, Tampa, FL; 2Tampa General Hospital, Tampa, FL
A 55-year-old male underwent laparoscopic cholecystectomy with choledochoscopy and ductal lavage for common bile duct clearance. The patient first underwent ERCP for stent placement, but a stone remained in the upper third of the common bile duct. During the cholecystectomy, the biliary tree was not successfully visualized, so we passed a choledochoscope through the cystic duct. We visualized dense fibrinous tissue that could not be traversed, so we utilized pulsatile lavage of injectable saline to break up the tissue and flush it into the common bile duct until the duct was cleared. We removed the scope and completed the operation. The patient experienced no complications.
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