Bile Duct Exploration
Bile Duct Exploration is a surgical that is used to see if something like a stone is blocking the flow of bile from your liver and gallbladder to your intestine.
Some facts about Bile Duct Exploration:
- Bile is made and released by the liver and then sent to the small intestine through bile duct, where it helps the body break down and absorb food.
- The liver, gallbladder, and pancreas are connected to the small intestine through bile duct.
- If anything, such as a stone, is blocking the flow of bile from the liver and gallbladder to the intestine can be found by Bile duct exploration procedure.
- Bile can back up into the liver if something is blocking the bile duct causing jaundice.
- The bile duct may be infected and an emergency surgery will be required if the stone or blockage is not removed.
- A bile duct exploration can be performed during the removal of the gall bladder.
- An ERCP (endoscopic retrograde cholangiopancreatography) is an alternative treatment or this.
- Complications from general anesthesia, swelling or scarring of the bile duct, bile leak, bleeding and infection are some of the risks with bile duct exploration.
Preparation for Bile Duct Exploration:
- Avoid eating and drinking anything at least four hours before your surgery.
- You may drink a sip of water with your medications if needed.
- Any history of bleeding disorders or are taking any blood-thinning (anticoagulant) medicines, aspirin, or other medicines that affect blood clotting should be informed to your healthcare provider as you may be asked to stop taking these medicines before your surgery.
Procedure for Bile Duct Exploration:
- The procedure is usually performed under general anesthesia.
- A small incision (cut) will be made by the surgeon in the abdomen.
- The bile duct will be located and a dye will be injected into the duct.
- An X-ray will be taken by the doctor, which shows where the stone or blockage is located.
- The doctor makes a cut into the bile duct if stones are found and removes them.
- A tube may be inserted into the bile duct which comes out the skin to drain bile into a bag outside the body.
- The bag will be remain in place from seven days to several weeks.
- The dye procedure may be repeated before removing your tube.
- You may have to stay in the hospital for one to four days after the procedure.
- Strenuous activity should be avoided for four to six days.
- Your discomfort will be relieved and the chance of infection and jaundice will reduced after the surgery.
- The laparoscopic common bile duct exploration is a potential option for managing stones.
- Laparoscopic common bile duct exploration can be performed either transcystic and through a choledochotomy.
- The cystic duct is exposed for 2 to 3 cm and scissors used to incise it in a Trancystic approach.
- A cholangiogram catheter is then introduced and this can be inflated if it has a balloon tip.
- 50 percent contrast is injected under fluoroscopy to confirm position and anatomy.
- The common bile duct can be flushed by using 30 cc of saline through the catheter.
- Fluoroscopic-guided basket retrieval can be performed, if flushing is inadequate to clear any small stones.
- A vertical ductomy performed for about 5 mm on the anterior surface of the duct, distal to the cystic-common bile duct junction after exposing the bile duct in Choledochotomy.
- The method of stone clearance are identical to the trans-cystic approach.
