Navigation by modified and dynamic intraoperative cholangiography during laparoscopic subtotal cholecystectomy for difficult gallbladder

Fumio Chikamori, MD; Ryo Yamada; Koji Ueta, MD; Kazuhisa Onishi, MD; Mitsuteru Yoshida, MD; Nobuyuki Tanida, MD; Hiromichi Yamai, MD; Hisashi Matsuoka, MD; Norihiro Hokimoto, MD; Sunao Uemura, MD; Jun Iwabu, MD; Kai Mizobuchi; Akira Marui; Niranjan Sharma, MD

Radiology Case Reports (Apr 2023)

Navigation by modified and dynamic intraoperative cholangiography during laparoscopic subtotal cholecystectomy for difficult gallbladder

Fumio Chikamori, MD,
Ryo Yamada,
Koji Ueta, MD,
Kazuhisa Onishi, MD,
Mitsuteru Yoshida, MD,
Nobuyuki Tanida, MD,
Hiromichi Yamai, MD,
Hisashi Matsuoka, MD,
Norihiro Hokimoto, MD,
Sunao Uemura, MD,
Jun Iwabu, MD,
Kai Mizobuchi,
Akira Marui,
Niranjan Sharma, MD

Affiliations

Fumio Chikamori, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan; Corresponding author.
Ryo Yamada: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Koji Ueta, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Kazuhisa Onishi, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Mitsuteru Yoshida, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Nobuyuki Tanida, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Hiromichi Yamai, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Hisashi Matsuoka, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Norihiro Hokimoto, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Sunao Uemura, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Jun Iwabu, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Kai Mizobuchi: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Akira Marui: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Niranjan Sharma, MD: Adv Train Gastroint & Organ Transp Surgery, 12 Scotland St, Dunedin, 9016, New Zealand

Journal volume & issue: Vol. 18, no. 4
pp. 1585 – 1591

Abstract

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We used modified and dynamic intraoperative cholangiography (IOC) navigation during laparoscopic subtotal cholecystectomy for difficult gallbladders. We have defined an IOC that does not open the cystic duct as a modified IOC. Modified IOC methods include the percutaneous transhepatic gallbladder drainage (PTGBD) tube method, the infundibulum puncture method, and the infundibulum cannulation method. Case 1 was chronic cholecystitis after PTGBD for acute cholecystitis with pericholecystic abscess. In this case, modified IOC was performed via PTGBD, and biliary anatomy and incarcerated stone were confirmed. Case 2 was chronic cholecystitis after endoscopic sphincterotomy for cholecystocholedocholithiasis. In this case, modified IOC was performed via gallbladder puncture needle, and biliary anatomy and incision line were confirmed. The target point on the laparoscopic image was determined by moving the tip of the grasping forceps under modified IOC, which we call modified and dynamic IOC. We conclude that the navigation by the modified and dynamic IOC via PTGBD tube or puncture needle is useful to identify biliary anatomy, incarcerated gallbladder stone, and safe incision line during laparoscopic subtotal cholecystectomy .

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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