Busy morning! Hope someone is able to help.
1. Laparoscopic lysis of adhesions
2. Laparoscopic cholecystectomy w/ intraoperative cholangiogram
adhesions in the right upper quadrant. port placed under direct vision. adhesions were lysis using electrocautery and sharp dissection. Approx 15 min of operative time.
peritoneum overlying the gallbladder was incised. Neck of gallbladder circumferentially dissected. cystic artery dissected due to it's anterior position and obstruction of view to cycstic duct. artery divided and clipped. gallbladder was extended and neck was circumferentially dissected.
cholangiogram catheter advanced throught gallbladder neck into cystic duct. gallbladder neck clipped and catheter noted to have good flow into duct. cholangiogram was taken and reviewed noted to have good visual of bilateral hepatic ducts, common duct, cystic duct, and good drainage into duodenum. no evidence of stones or obstructions.
duct circumferentially dissected, duct then divided. Gallbladder dissected from liver bed. abdom irrigated.....
1. Laparoscopic lysis of adhesions
2. Laparoscopic cholecystectomy w/ intraoperative cholangiogram
adhesions in the right upper quadrant. port placed under direct vision. adhesions were lysis using electrocautery and sharp dissection. Approx 15 min of operative time.
peritoneum overlying the gallbladder was incised. Neck of gallbladder circumferentially dissected. cystic artery dissected due to it's anterior position and obstruction of view to cycstic duct. artery divided and clipped. gallbladder was extended and neck was circumferentially dissected.
cholangiogram catheter advanced throught gallbladder neck into cystic duct. gallbladder neck clipped and catheter noted to have good flow into duct. cholangiogram was taken and reviewed noted to have good visual of bilateral hepatic ducts, common duct, cystic duct, and good drainage into duodenum. no evidence of stones or obstructions.
duct circumferentially dissected, duct then divided. Gallbladder dissected from liver bed. abdom irrigated.....