Transcystic Common Duct Exploration

Extra Equipment:
-1mg Glucagon
-4Fr Fogarty balloon
-8Fr Angioplasty balloon
-Arrow cholangiogram set, containing metal introducers and balloon cholangiocatheter.
-choledochoscope with saline irrigation 3L
-guide wire
-wire basket

Procedure in detail:
The cystic duct was exposed for approximately 2-3cm and a ductotomy was created. Cholangiogram was performed. The cystic duct was then dilated with the arrow balloon catheter. The choledochoscope was inserted into the ductotomy and advanced into the common bile duct. Once the common duct stone was visualized, I inserted a wire basket through the choledochoscope past the obstruction. The basket was opened and pulled back around the stone. The stone, basket, and choledochoscope were then pulled back and removed through the ductotomy.