LAPAROSCOPIC CHOLECYSTECTOMY AND CHOLEDOCHOLITHOTOMY

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LAPAROSCOPIC CHOLECYSTECTOMY ANDCHOLEDOCHOLITHOT
OMY
H I L S

• PRESENTED BY DR. NARSAIAH .B
  M.S, FAIS, FICS

• HYDERABAD INSTITUTE OF LAPAROENDOSCOPIC
  SURGERY

CONTACT ADITYA HOSPITAL OPP ANDRA
SARASWATI PARISHAD, TILAK ROAD, ABIDS, HYD. Ph
4752988, 4754153.
?
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PATIENT SELECTION

• PATIENTS WITH SUSPECTED AND CONFIRMED STONES
  (CBD) WERE TAKEN.
• ALL PATIENTS HAD DILATED CBD .
• STONES ARE LARGE (AND) OR MULTIPLE.
• FAILED ERCP AND EXTRACTION OF STONES.
• ALL SUSPECTED CASES OF MALIGNANCY EXCLUDED
  FROM STUDY.
• FITNESS FOR GENERAL ANAESTHESIA.

H I L S
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CENSUS
TOTAL NO. OF PATIENTS
25
H I L S
YES 3
NO 22
NO 2
YES 23
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US EXAMINATION
BIOCHEMICAL
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L.C CINSTRUMENTATION

• ROUTINE VIDEO LAPAROSCOPIC EQUIPMENT.
• 30 DEGREE TELESCOPE.
• RIGID URETROSCOPE, CYSTOSCOPE, AND ACCESSORIES.
• C-ARM FACILITY

H I L S
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L.C CPROCEDURE

• POSITION, PORTS, PROCEDURE LIKE LAP
  CHOLECYSTECTOMY.
• ADDITION PORT IN EPIGASTRIUM.
• DISSECTION, ISOLATION AND LIGATION OF
  CYSTIC DUCT.
• PER OP CHOLANGIOGARAM PASSING CATHETER THROUGH
  CYSTIC DUCT.
• CHOLEDOCHOSCOPY VIA CYSTIC DUCT OR
  CHOLEDOCHOTOMY.
• T-TUBE INSERTION AND CLOSURE.

H I L S
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L.C COPERATION DETAILS

• OPERATION TIME 1 TO 3 HRS.
• BLOOD TRANSFUSION NIL.
• MORTALITY NIL.
• MORBIDITY NIL.
• NO RECURRENT OR RETAINED STONES ON TWO YEAR
  FOLLOWUP.

H I L S
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COMPARISON
ERCP LAP.CHOLE
L.C C
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TWO OR MORE
ONE
H I L S
TWO
ONE
LESS OR NIL
MORE
DIFFICULT
POSSIBLE
DIVIDED
NOT DIVIDED
COMMON
NIL
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H I L S
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L.C CCONCLUSION
LAPAROSCOPIC CHOLECYSTECTOMY AND
CHOLEDOCHOLITHOTOMY IS BETTER ALTERNATIVE
MANAGEMENT OF C.B.D STONE OVER ERCP AND
CHOLECYSTECTOMY, AND WITH GOOD EXPERTISE IN
LAPAROSCOPIC SURGERY IT EVOVLES AS STANDERD
PROCEDURE.
H I L S
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THANK YOU
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H I L S
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