Laparoscopic Transcystic CBD Exploration
- Perform a cholangiogram.
- After establishing the stone burden, replace the cholangiogram catheter with either a basket extraction implement or choledochoscope.
- Use glucagon to relieve sphincter pressure along with transcystic flushing of the duct with saline to force debris into the duodenum.
- In cases of stone impaction, use Fogarty balloon catheters to help free the stones.
- Place retrieved stones in a safe spot in the abdomen and eventually in a specimen bag with the gallbladder.
- Completion cholangiogram.