Laparoscopic Common Bile Duct Exploration Using a Standard Gastroscope and Simple Accessories in a Resource-Limited Setting: A Case Report and Review of Literature
Niranjana PB
*
Sarji Renuka Deodhar Hospital, Haveri, Karnataka, India.
Dhananjaya Sarji
Sarji Group of Hospitals, Sarji Institute, Karnataka, India.
Madhu K R
SRD Haveri, Karnataka, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Laparoscopic common bile duct exploration (LCBDE) is a recognized treatment for choledocholithiasis. Dedicated choledochoscopes and retrieval accessories facilitate the procedure but may be unavailable in resource-limited centers.
Case Presentation: We report a 51-year-old male with intermittent itching and fever for two years. Imaging showed a distal common bile duct (CBD) stone measuring 1.5 cm with a CBD diameter of 10 mm. LCBDE was performed using a standard upper gastrointestinal gastroscope for intraductal visualization. The stone was retrieved using a Roth net and biopsy forceps. The choledochotomy was closed transversely with interrupted 4-0 PDS sutures without a stent or T-tube. The patient recovered uneventfully and was discharged on postoperative day 2. Follow-up at one month showed no complications.
Conclusion: LCBDE can be safely and effectively performed using a standard gastroscope and simple instruments in selected cases within resource-limited settings. Larger series and longer follow-up are needed to confirm long-term safety and ductal patency.
Keywords: Laparoscopic CBD exploration, gastroscope, choledochoscopy, stone extraction, minimal access surgery, resource-limited setting