Laparoscopic Bile Duct Exploration
Laparoscopic bile duct exploration is usually performed at the same time as a laparoscopic cholecystectomy in a certain group of patients. The bile duct is a hollow tube running from the liver to the small bowel and provides a passage for the flow of bile. Stones slipping out of the gall bladder and into the bile duct can cause obstruction and jaundice – a yellowing of the skin and eyes as well as acute pancreatitis. Stones within the bile duct may be detected by investigations performed before the operation or alternatively, with an ultrasound scan performed as part of a laparoscopic cholecystectomy.
The aim of the operation is to remove stones lodged in the common bile duct by making a small cut and passing a camera up and down the duct to visualise the stones before removing them. The opening in the duct is then closed using sutures. A drainage tube is left inside the abdomen at the end of the operation.
As with all laparoscopic procedures, there is a chance this may need to be converted to an open procedure,I if there are technical problems or scar tissue makes the operation difficult.
This operation requires overnight hospital stay for monitoring. Most patients go home the next day although occasionally there can be a small leakage of bile in the drain which settles in a few days. The recovery period is usually the same as that for a cholecystectomy.
An alternative to bile duct exploration is ERCP (Endoscopic retrograde cholangiopancreatography).This is not an operation but involves passing a camera through the mouth and into the small intestine to remove the stones. Sometimes a small cut is made in the muscle of the bile duct to allow the stones to pass, or a plastic tube (stent) is left in place to allow the bile to flow freely. You will be sedated for this, but not fully asleep, and can usually go home on the same day.