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Abstract No.:

PP21.07

Name of the Presenter : Prof. R. Sinha

Transdochal CBD exploration Prof Rajeev Sinha HOD MLB Medical College JHANSI


Abstract No.:

PP21.07

Name of the Presenter : Prof. R. Sinha

Aim

• Feasibilityy studyy • Assessment of operative parameters • Assessment of postoperative parameters

Methodology ¾ 32pts ¾ 4mm-0deg-urethroscope OR 17FG-6deg-nephroscope ¾ 5 ports


Abstract No.:

PP21.07

Name of the Presenter : Prof. R. Sinha

Ligated Cystic duct

Dissected CBD - Incision with endoknife / harmonic / cautery


Abstract No.:

PP21.07

Name of the Presenter : Prof. R. Sinha

Nephroscopic view

CHD and Intrahepatic biliary channels

Stone in distal CBD


Abstract No.:

PP21.07

Name of the Presenter : Prof. R. Sinha

4 mm Stone crusher in use

Fragmented stone


Abstract No.:

PP21.07

Name of the Presenter : Prof. R. Sinha

Intact stone removal –using grasper

Post stone removal Normal Ampullary opening seen


Abstract No.:

PP21.07

Name of the Presenter : Prof. R. Sinha

T tube Tt b in i place l - optional ti l


Abstract No.:

PP21.07

Name of the Presenter : Prof. R. Sinha

Closure without T tube


Abstract No.:

PP21.07

Name of the Presenter : Prof. R. Sinha

• • • • •

45 -105 min T tube in -7 pts Morrison’s Morrison s pouch draindrain ALL pts Discharge – 4 d Results ¾

Bile drainage > 4days ¾ Port site infection (2) ¾ Retained stones (2) ¾ Conversion

(1)pt

(5)

COMPARABLE TO OPEN CBD EXPLORATION RESULTS


Abstract No.:

PP21.07

Name of the Presenter : Prof. R. Sinha

CONCLUSIONS

• Requires advanced Lap expertise • Significant increase in operating time BUT • Marked reduction in morbidity

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